Preamble

The House met at half-past Nine o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

Orders of the Day — Osteopaths Bill

As amended (in the Standing Committee), considered.

[MADAM SPEAKER in the Chair]

New clause 1

DATA PROTECTION AND ACCESS TO PERSONAL HEALTH INFORMATION

'.—(1) In section 2(1) of the Access to Health Records Act 1990 (definition of health professionals), after paragraph (f) there shall be inserted—
(ff) a registered osteopath;".

(2) The following instruments shall be amended as mentioned in subsection (3)—

(a) the Data Protection (Subject Access Modification) (Health) Order 1987;
(b) the Access to Personal Files (Social Services) Regulations 1989;
(c) the Access to Personal Files (Social Work) (Scotland) Regulations 1989;
(d) the Access to Personal Files (Housing) Regulations 1989; and
(e) the Access to Personal Files (Housing) (Scotland) Regulations 1992.

(3) In each case, at the end of the Table in the Schedule there shall be inserted—
Registered osteopath Osteopaths Act 1993, section 39.

(4) The reference in section 2(1) of the Access to Medical Reports Act 1988 to the order mentioned in subsection (2)(a) shall be read as a reference to that order as amended by this section.

(5) The amendments made by this section shall not be taken to prejudice the power to make further orders or (as the case may be) regulations varying or revoking the amended provisions.'.—[Mr. Moss.]

Brought up, and read the First time.

Mr. Malcolm Moss: I beg to move, That the clause be read a Second time.
The proposal is a straightforward one. The Access to Health Records Act 1990 gives patients a right of access to their health records. It applies to records relating to the physical or mental health of an identifiable individual compiled by a health professional in connection with care and treatment. "Health professional" is defined without reference to osteopaths, and records compiled and held by an osteopath are therefore outside the scope of the Act.
As the main purpose of my Bill is to introduce a statutory registration scheme for osteopaths, to place the profession on the same footing as the other key health

professions, it seems logical for individuals who have received treatment from an osteopath to be given the legal right of access to the records of that treatment.
The definition of "health professional" is the same across the whole range of legislation that deals with the individual's right of access to information about his own health. For the sake of consistency, it is again logical to include registered osteopaths in all the various legislation—that is especially important in respect of the Data Protection (Subject Access Modification) (Health) Order, as the Access to Health Records Act applies only to records compiled in a written form. An individual's right of access to information held in computerised form is provided by the subject access provisions of the Data Protection Act 1984.

The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville):: Scanning the horizon for good news this morning, I am happy to light upon the excellent Bill introduced by my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss).
This new clause is an important proposal, which the Government strongly support. For many years, we have openly supported the principle that patients should, as a matter of course, have the right to know what has been written about them. The new clause extends to individuals who receive treatment from osteopaths the existing rights of patients to have access to their health records.
People have had a legal right of access to personal health information for some time now. Health records kept on computer are accessible to patients by means of section 21 of the Data Protection Act 1984, although certain information is exempt by virtue of the Data Protection (Subject Access Modification) (Health) Order 1987. Those exemptions are necessary to protect the subject from serious harm to his physical or mental health and to protect the privacy of other identifiable individuals.
In 1987, the hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) successfully piloted on to the statute book the Access to Personal Files Act, which gave individuals the right of access to records not held on computer—usually described by the rather unsophisticated term "manual records"—but that right extended only to those manual records held by local authorities and local social services for the purposes respectively of their housing and social services functions.
Health records were excluded from the Access to Personal Files Act 1987 because, at that stage, the Government wanted to reach an agreement with the medical profession, which had reservations about the idea of a legal right of access to health records. The profession was concerned about the potential effects on patient care of patients being handed that right, and argued that arrangements for access should involve appropriate safeguards for patients, doctors and other health professionals. It recognised that, in any case, many doctors had long practised voluntary disclosure to patients of their personal records, and argued that legislation was not necessarily the right way in which to deal with the issue. Therefore, the Government undertook to enter into talks with the medical profession to see what could be achieved.
After discussions, which extended over two years, with representatives of the profession, a draft code on non-statutory access to health records was produced. That document was circulated widely for comments. The only reservations about the principle of access were raised by


the medical profession itself. For that reason, the Government concluded that agreement could not be reached on a non-statutory code which would match the expectations of the public and which would have the unequivocal support of the medical profession.
When the hon. Member for Newcastle upon Tyne, North (Mr. Henderson) presented his Access to Health Records Bill in 1989, the Government decided to support it, subject to necessary safeguards because its provisions were entirely consistent with my Department's policy on access to records. The issue is not just letting patients see their own health records. Medical records are maintained for patient care and are used by doctors and other health professionals to help them in the diagnosis of patients. Records are thus used to record and advise other health professionals on the progress of care and treatment.
However, the primary purpose is to record what is in the best interests of patients and what is in the record may not always be in the best interests of the patient to know. For example, there may be circumstances in which the uncontrolled disclosure of information may cause harm or distress.
Therefore, the problem has been to ensure that information for patients is recorded properly, while providing safeguards for patients against the risks that some disclosures may bring. Some doctors are fond of using phrases and medical jargon in records which many people find incomprehensible. That is why the legislation provides that the applicant should be given a simple and clear explanation of the meaning of the record by a relevant health professional, whether or not the applicant requests clarification.
A right of access to records can be reassuring to patients who know that they may see their records at any time. If patients ask to see their records and detect misleading or inaccurate information, they can request that that information be corrected. The Access to Health Records Act 1987 specifically provides for that. One of the advantages of the right of access is that it forces those who compile records to think rather more carefully about what they write. Openness therefore acts as a safeguard against possible casual, ill-considered personal comments which are sometimes found on health records.
In paying tribute to hon. Members who have successfully introduced Bills that have given individuals greater access to records, I must also acknowledge the work of the Campaign for Freedom of Information in raising public consciousness on this issue. The campaign has argued with much success that people should have the right of access to information that affects them and to information that enables them to take decisions about their lives. Those principles lie at the very heart of the Government's policy on openness.
The patients charter has highlighted the existing right of access to one's own health records. That, coupled with the right to be given detailed information on local health services, enables patients to make more informed decisions and illustrates the development of a more patient-centred health service taking account of the wishes of patients. With access to information, patients are empowered to play a greater role in decisions that affect them.
The issue of patients' access to their own health records is part of the wider issue of the provision of information to

patients. Before legislation, there was a great deal of evidence that patients were not given as much information about their condition as they would like. For example, a survey of patients' satisfaction in general practice found that lack of information concerning treatment was the most frequently reported deficiency in the service provided.
Access to health records has provided an important new freedom to people, particularly because we should all be encouraged to take more responsibility for our health. We increasingly want to know what to do to keep ourselves healthy and what we can do to improve our chances of a quick recovery when we are ill. We want to be able to discuss our treatment with doctors and the other health professionals involved in caring for us, to understand what we are being asked to consent to and to know the risks, alternatives and chances of success.
Of course, access to the written record is not an alternative to discussion with professionals. However, I am sure that being able to see and understand what has been recorded about one helps to make that discussion more informed and equal and it will therefore become a more natural process between patient and professional.
The Government welcome and support the new clause. Given the enhanced status that the Bill gives to the profession of osteopathy in the field of health, extending patients' rights of access to the records of a registered osteopath seems the natural and logical progression.

Ms Dawn Primarolo: We welcome and support the new clause. As the Minister said, in a Bill that is designed to protect patients' rights and access to osteopaths in terms of training and the quality of service that patients receive from osteopaths, it is entirely right that they should have access to their own records and protection in that way.
I sincerely hope that the positive way in which we have started our discussion on the Bill today is a sign that we shall be able to progress speedily through a Bill which should have been on the statute book a long time ago and which has the support of all parties—although representatives of one party are absent from the Chamber today.
9.45 pm
I expect that the Liberal Democrats are still celebrating, and we would not want to take that from them after their spectacular victories against the Government—[Interruption.] I could recount all the shire counties that were lost—

Mr. Deputy Speaker (Mr. Michael Morris): Order. A general reference to that may be acceptable, but we do not need to explore the depths.

Ms Primarolo: I was encouraged by some sedentary comments, and I stand corrected, Mr. Deputy Speaker.
I can think of no better basis from which the Government can look to the horizon to redeem themselves than to improve and develop the national health service and to take the message from the electorate yesterday that they expect the Government to do that and that they have not approved of the Government's progress thus far. I therefore hope that we shall be able to support all the proposals in the Bill and conclude our business in good time so that we can return to our constituencies and continue the work that we were doing yesterday.

Question put and agreed to.

Clause read a Second time, and added to the Bill.

New clause 3

APPEALS AGAINST DECISIONS OF THE HEALTH COMMITTEE

'.—(1) Any person with respect to whom a decision of the Health Committee is made under section 23 may, before the end of the period of 28 days beginning with the date on which notification of the decision is sent to him, appeal against it in accordance with the provisions of this section.

(2) An appeal under subsection (1) shall lie to an appeal tribunal, consisting of a chairman and two other members, established for the purposes of the appeal in accordance with rules made by the General Council for the purposes of this section.

(3) The General Council shall make rules as to the procedure to be followed by an appeal tribunal hearing an appeal under this section.

(4) The rules may, in particular, make similar provision to that made by virtue of section 26(2)(d), (f), (g), (h), (i) or (j).

(5) No decision against which an appeal may be made under this section shall have effect before—

(a) the expiry of the period within which such an appeal may be made; or
(b) the appeal is withdrawn or otherwise disposed of.

(6) The chairman of an appeal tribunal—

(a) shall be selected in accordance with rules made by the General Council; and
(b) shall be qualified as mentioned in section 27(4).

(7) Each of the other two members of an appeal tribunal shall be selected in accordance with rules made by the General Council—

(a) one of them being a fully registered osteopath, and
(b) the other being a registered medical practitioner.

(8) The rules may not provide for the selection of any member of an appeal tribunal to be by the General Council.

(9) The chairman of an appeal tribunal shall appoint a person approved by the members of the tribunal to act as clerk of the tribunal.

(10) Subject to any provision made by the rules, an appeal tribunal shall sit in public and shall sit—

(a) in Northern Ireland, in the case of an osteopath whose registered address is in Northern Ireland;
(b) in Scotland, in the case of an osteopath whose registered address is in Scotland; and
(c) in England and Wales, in any other case.

(11) On any appeal under this section—

(a) the appeal shall be by way of a rehearing of the case;
(b) the General Council shall be the respondent; and
(c) the tribunal hearing the appeal shall have power to make any decision which the Health Committee had power to make under section 23.

(12) An appeal tribunal shall have the same powers of interim suspension as the Health Committee has under section 24(1)(b) and that section shall have effect in relation to suspension orders made by appeal tribunals with the necessary modifications.

(13) No person shall be required by any rules made under this section to give any evidence or produce any document or other material at a hearing held by an appeal tribunal which he could not be compelled to give or produce in civil proceedings in any court in that part of the United Kingdom in which the hearing takes place.

(14) An appeal tribunal shall have power to award costs.

(15) Any expenses reasonably incurred by a tribunal, including any incurred in connection with the appointment of a clerk, shall be met by the General Council.'.—[Mr. Moss]

Brought up, and read the First time.

Mr. Moss: I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker: I understand that with this it will be convenient to discuss also the following amendments: No. 18, in clause 30, page 24, line 12 leave out
'of the Health Committee is made under section 23'
and insert

'is made by an appeal tribunal hearing an appeal under section (Appeals against decisions of the Health Committee)'.

No. 19 in page 24, line 21, at end insert—
'() An appeal under subsection (1)(b) may only be on a point of law.

No. 20, in page 24, line 24, leave out 'may appear as' and insert 'shall be the'.

No. 21, in page 24, line 39, after 'Committee' insert 'or appeal tribunal'.

No. 22, in page 24, line 42, leave out subsection (8).

No. 23, in page 25, line 7, leave out from 'by' to 'rules', in line 8, and insert

'—

(a) the Professional Conduct Committee,
(b) the Health Committee, or
(c) an appeal tribunal hearing an appeal under section (Appeals against decisions of the Health Committee), under'.

No. 24, in page 25, line 8, after '(h.)' insert
'or under any corresponding rules made by virtue of section (Appeals against decisions of the Health Committee) (4)'.

No. 28, in page 26, line 20, leave out 'or 17' and insert
'17 or (Appeals against decisions of the Health Committee)'.

Mr. Moss: The central purpose of the Bill is to establish a statutory registration system for osteopaths to provide members of the public with the assurance that, in the future, anyone calling himself or herself an osteopath, is adequately trained, properly qualified and fully competent to practise osteopathy, and that their professional practice is regulated by effective methods of control.
In addition to providing those safeguards for the public, it is equally important that the statutory scheme protects the human rights of osteopaths and provides them with an appeals system which is firmly rooted in the principles of natural justice.
As currently drafted, the Bill provides an aggrieved osteopath with a right of appeal against decisions of the professional conduct committee and health committee to Her Majesty in Council—that is, to the Judicial Committee of the Privy Council. I remind the House that those two committees are the fitness to practise committees with powers to suspend an osteopath's registration, impose conditions on his or her continuing to practise or, in the case of the professional conduct committee, to erase his or her name from the register.
Providing appeals against decisions of the health committee on matters of fact as well as of law would be a unique feature of the osteopaths' scheme among those governing other health professionals. The Judicial Committee is, however, concerned that appeals on matters of fact are liable to raise complicated issues of technical evidence on someone's medical condition and their consequent ability to practise which would fall outside the scope of its competence to determine. Therefore, new clause 3 seeks to provide an alternative route for appeals against decisions of the health committee.
Under the provisions of new clause 3, an appeal on either a matter of fact or of law would lie to an appeal tribunal. A further right of appeal against a decision of that tribunal on a point of law only would lie to Her Majesty in Council. That would be in line with the practice applying to the other health professionals.
The appeal tribunal would comprise a legally qualified chairman—a senior solicitor or barrister—a fully registered osteopath and a registered medical practitioner, all of whom would be appointed in accordance with rules drawn up by the general council and approved by the Privy


Council. In order to ensure the independence of the appeal tribunal from the general council, the rules must specifically prohibit the general council from selecting any member of the appeal tribunal.
A different appeal tribunal will be constituted for each appeal and, subject to any provisions made by the rules, would sit in Northern Ireland in cases where the appeal has been by an osteopath whose registered address is in Northern Ireland, in Scotland if his or her address is in Scotland, and in England or Wales in any other case. Subject again to any provision made by rules, the appeal tribunal will sit in public.
Hon. Members will no doubt have noticed that that is in contrast with the provisions of amendment No. 17, which I shall discuss later. We shall provide for hearings of the health committee to be held in private. That difference does not betray a contradiction in policy. In the first instance, an appeal under this new clause would have been initiated by the osteopath himself rather than by another party, as would be the case with the original allegation.
Also, the provisions have been drafted with an eye on the terms of article 6.1 of the European convention on human rights, which states:
In the determination of his civil rights and obligations or of any criminal charge against him, everyone is entitled to a fair and public hearing within a reasonable time by an independent and impartial tribunal established by law.
The appeal to the appeal tribunal would be by way of a rehearing at which the general council would be the respondent. The appeal tribunal would possess the same powers as the health committee to require a witness to attend the hearing and give evidence or produce documents. Those powers would be backed up by the provisions of clause 31, making failure to comply a criminal offence.
The appeal tribunal would be empowered to make any decision that the health committee would have the power to make under clause 23. In the same way, the appeal tribunal would have comparable powers of interim suspension, as in relation to the health committee by virtue of clause 24(1)(b).
The other amendments in this group are the consequential amendments required to clauses 30, 31 and 35. In particular, they would provide for the rules to be prepared by the general council under this clause to be subject not only to approval by the Privy Council but to the negative parliamentary procedures. They also provide for the general council to be the respondent to any further appeal made to the Judicial Committee of the Privy Council on a point of law.
Such hearings would normally be adversarial. However, as currently drafted, the Bill provides only that the general council may appear as the respondent. It is now felt, however, that the general council should always be the respondent. By making the general council the respondent, the provisions in clause 30(8) relating to the apportioning of costs are not required. The general council would automatically be a party to the hearing and could therefore be liable to incur the costs of the parties.

Sir Nicholas Bonsor (Upminster): I welcome the provisions that my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) has introduced, and I take his point in regard to the reluctance of the Judicial Committee of the Privy Council to be faced with

complicated matters of medical fact in which it would not feel itself qualified to make a decision. Thus, it is correct to limit the right of appeal to the Judicial Committee to points of law. There are, however, one or two detailed matters in regard to new clause 3 to which I draw the attention of the House and in particular ask my hon. Friend to address to see whether further amendments could be made at a later stage of the Bill's process.
The first point that worries me is that the general council has virtually unfettered powers to make rules. Therefore, it is very difficult for the House to consider new clause 3 and to satisfy itself that the rules of justice—natural justice—will be fully carried out when the general council makes decisions over which it has no control.
I am happy that the appeal tribunal should be chaired by a lawyer. It is terribly important—I speak as somebody who practised at the Bar—that people with legal qualifications chair such committees. There is always a temptation to denigrate the legal profession and to underestimate the value of putting lawyers on lay tribunals on which their advice on what is fair, right and in accordance with the concepts of our law can be extremely useful.
I am pleased that the chairman is to be a lawyer, but I am a little less happy that the rules are so clear on what both the other members of the tribunal have to be. There has to be one osteopath, and one registered medical practitioner. It might be appropriate to have somebody with a different background, interest and knowledge on the appeal tribunal in circumstances which I cannot currently guess but which might arise.
My hon. Friend will take the point that the reason why he is leaving the rules so general for the committee to consider later is precisely that, and to fetter the committee in that way on that specific issue seems to be unwise and contrary to the general thinking behind the clause.
The second point, which is possibly more serious, is that new clause 3(4) states:
The rules may, in particular, make similar provision to that made by virtue of section 26.
There are then many sub-paragraphs. In clause 26, the position is different. It deals with the setting up of the health committee and the rules that the health committee shall decide on. It states:
The rules shall, in particular, include provision".
There we have the health committee being bound to make rules along the lines of that clause, but that compulsion is removed when it comes to the appeal committee, which has discretion whether to follow the rules laid down in clause 26.
What concerns me in particular is that clause 26(2)(d) states:
The rules shall, in particular, include provision … entitling the osteopath to be legally represented at any hearing in respect of the allegation".
If I read that clause correctly—I stand to be corrected if somebody can so persuade me—what is substituted for that in new clause 3 is that the rules may, in particular, include a provision entitling the osteopath to be legally represented at any hearing. If that reading is correct, it would, at least in theory, enable the appeal tribunal to refuse legal representation to an osteopath who has appealed to it.
I cannot believe that that is the intention behind the drafting of the Bill, and I should be grateful if my hon. Friend would confirm that, if I am right, that point will be


rectified. It would be a most unfortunate lacuna if that went on to the statute book without its being intended to have the effect which I believe it has.
More generally, I very much welcome the setting up of the appeal tribunal. I am sure that it will be invaluable and I am particularly pleased that it is specifically set down that the appeal shall be by way of a rehearing of a case. Therefore, there can be no danger of an osteopath being fobbed off with an appeal that would be taken by way of written evidence, for example, or would look only at the evidence that had been presented to the original hearing. I am confident that the appeal tribunal will offer justice to osteopaths, with the provisions that I have already expressed as being my doubts about it.
I do not need to trouble the House any longer on the new clause, provided that my hon. Friend, who is now consulting his advisers, can satisfy me on those points.

Mr. Sackville: I formally signal the Government's support for the new clause and recognise the co-operation and support of the medical and legal professions, which have been extremely helpful in drawing up the new clause.

Lady Olga Maitland: I give a warm welcome to the new clause and express my support for it. A rigorous procedure for the appeal system is essential especially as we are giving the osteopathic profession official status. It will certainly give confidence to patients to know that no stone will be left unturned in the system that will determine the fitness of osteopaths to return to the profession.

10 am

Mr. Moss: I should like to respond to my hon. Friend the Member for Upminster (Sir N. Bonsor). His first point was that the council could make its own rules. He felt that that was to give it perhaps a little too much licence. I remind him that any rules which the council may come up with will be subject to the approval of the Privy Council and, of course, as a result may be subject to parliamentary scrutiny.
My hon. Friend referred to the composition of the tribunal. Taking first his point about the chair being a lawyer, I am glad that he declared an interest. But he seemed to speak most of the time about the interests of his profession. We believe that it is extremely important that a lawyer should chair the tribunal. We also believe that the inclusion of an osteopath and a medical adviser is vital. The osteopath could comment on professional matters of osteopathy and the running of the practice by the osteopath. The doctor could advise on health matters. Let us face it: the appeal will be to a health tribunal on health matters.
My hon. Friend raised the difference between the wording "may" and "shall" in terms of making the rules. The general council will be required to make rules and the Privy Council will scrutinise them. It is difficult to believe that the Privy Council would not take the important points that my hon. Friend raised into account. In no circumstances would it countenance an individual not having legal representation on any of the investigatory committees of tribunals.

Question put and agreed to.

Clause read a Second time, and added to the Bill.

Clause 6

REGISTRATION: SUPPLEMENTAL PROVISION

Mr. Moss: I beg to move amendment No. 1, in page 5, line 24, at end insert '-(a)'.

Mr. Deputy Speaker: With this, it will be convenient to discuss also the following amendments: No. 2, in page 5, line 25, at end insert 'and
(b) the address at which he has his practice or principal practice or, if he is not practising, such address as may be prescribed.

No. 3, in page 6, line 9, at end insert—
'(m) the meaning of "principal practice" for the purposes of subsection (1).

No. 29, in clause 39, page 28, line 20, leave out 'as his address'.

Mr. Moss: Amendment No. I will require the statutory register to show the osteopath's practice or principal practice address as well as the type of registration—full, conditional or provisional—that he or she holds. The register forms the heart of the statutory scheme. It will provide the assurance to members of the public that a practitioner whose name appears in the register has been appropriately trained, is properly qualified and is fully competent in the practice of osteopathy.
The provisions of clause 37 exempt osteopaths from the rehabilitation of offenders legislation, and place them under an obligation to declare all their criminal convictions, including spent convictions if asked, when applying for registration. So members of the public will be provided with an additional assurance as to a registered practitioner's bona fides and character.
The statutory register will elevate the scheme from the current system of voluntary registration. Voluntary registration has worked exceptionally well for the majority of practitioners. It has also played a key role in paving the way for statutory regulation. However, by its very nature, the voluntary system cannot enforce standards of competence or conduct. If a practitioner chooses not to participate in the scheme, the body that administers the scheme is completely powerless to exercise any jurisdiction over that individual's practice. That fundamental weakness brings into sharp focus the need for a statutory scheme.
As the law currently stands, anyone can call himself an osteopath and set up in practice. There is no obligation to undergo formal training of any nature or to comply with the standards of professional competence. Through the establishment of a statutory register maintained by a statutory council, standards of training, education, proficiency and professional conduct can be enforced throughout the profession in the United Kingdom. The statutory scheme will also require anyone who wishes to practise as an osteopath to conform to the standards set, to be registered on the statutory register and to submit himself to the authority of the statutory council.
Recording the address of a practising osteopath's practice or principal practice will not only provide members of the public with an essential piece of additional information—where to go for treatment—but will play a vital role in the election of members to the general council. The latter point will also apply to the address shown on the register for non-practising osteopaths. The precise detail is set out in the schedule which we shall examine later.
I draw the attention of hon. Members to paragraph 9 of the schedule. It specifies that eight of the osteopathic members of the general council are to be elected by fully registered osteopaths whose registered addresses are in England. Three others are to be elected by fully registered osteopaths with registered addresses in Wales, Scotland and Northern Ireland—one from each of the three countries. The schedule also provides for a 12th member, who must be a registered medical practitioner at the time of his election, to be elected by fully registered osteopaths whose registered addresses are in the United Kingdom.
We spent some time thinking about the address that should appear on the register in the case of a non-practising osteopath. Our initial instinct was to select the osteopath's home address, which would have been defined more precisely in the rules. However, two examples came to mind to discount that option. The first was the case of a practitioner who might no longer be in current practice but was widely respected within the profession and had established a clinic, perhaps under his or her name, which attracted practitioners of the highest calibre and was held in the highest esteem by its clientele.
Although no longer in current practice, the practitioner might continue to hold the reins of the clinic and may be regarded as the driving force behind its success. Such a person would undoubtedly want the address shown in the register against his name to be that of the clinic rather than his home address, regardless of how "home" was described in the rules.
The second example raised arguably more serious anxieties. A practitioner might have received menacing threats sufficient to make him consider temporarily suspending practice or, even worse, to make him cease practising because the threats so affected him that he was no longer able to practice. The worst thing that such a person could face if he decided to withdraw from current practice would be the appearance of his home address in the register because he chose to maintain his registration.
I accept that the examples are fairly extreme. Setting them aside, it is likely that some osteopaths will wish to keep their professional and private lives separate and, for such reasons, will not want their home address to be shown on the register. For all those reasons, it is felt that the matter should be left to the rules. The rules could provide a list of different types of address which a non-practising osteopath could choose to be recorded on the register.

Mr. Quentin Davies: Clause 6 is the heart of the Bill because it establishes the register which distinguishes a professional osteopath from simply anyone who decides to use that term. Clause 6 is extremely important if the Bill is to get on to the statute book. Over the years and the generations, there has been considerable scepticism by the medical profession about osteopathy and practitioners of other forms of what is now called complementary or alternative medicine.
Before I came here to speak today, I took advice from a member of the medical profession for whose judgment I have the highest regard—my father. He tells me that, in 40 years of medical practice, he has never yet referred a patient to an osteopath. He has never yet come across a case in which he believed that the conventional medical disciplines of orthopaedics and physiotherapy were insufficient to deal with the complaints for which

osteopaths believe that their talents make them exceptionally qualified. Nevertheless, my father, in common with many members of the medical profession, has an open mind and, what is more, he has no doubt as to the integrity of osteopaths. No doubt there are some bad apples in that profession, just as there are in any other profession or activity.
It can only contribute to the confidence of the public and that of the medical profession to advise people whether an osteopath might be able to contribute something to the treatment and cure of symptoms, if it is absolutely clear who is and who is not an osteopath. Such confidence will also be enhanced if everyone is clear about the definition of the word "osteopath". It is therefore essential that we have such a register.
I congratulate my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on his success in steering the Bill through Committee. He has put a great deal of hard work and careful thought into the Bill, and I have considerable regard for his judgment. That encourages me to offer the Bill my general support.
If the general council is to have the responsibilities set out in clause 6 conferred on it, there should be no doubt about its proactive role. There should be no doubt about the precision and rigour with which the register will be drawn up and maintained. It is therefore important that the amendments proposed by my hon. Friend the Member for Upminster (Sir N. Bonsor), in particular amendment No. 2, which leave out "may" and inserts "shall"—

Mr. Deputy Speaker: Order. the hon. Gentleman is talking about amendment No. 48, which we have not yet reached. Amendment No. 2 refers to the address of an osteopath.

Mr. Davies: I hope that I will be able to catch your eye, Mr. Deputy Speaker, when we reach amendment No. 2.
If we are to have a register, a name and address must be provided. There should be no misunderstandings about that address and, therefore, the proposed amendments greatly contribute to the precision and the credibility of the Bill.

Amendment agreed to.

Amendment made: No. 2, in page 5, line 25, at end insert
'and
(b) the address at which he has his practice or principal practice or, if he is not practising, such address as may be prescribed.'.—[Mr. Moss.]

Sir Nicholas Bonsor: I beg to move amendment No. 48, in page 5, line 26, leave out 'may' and insert 'shall'.
I am grateful for all that my hon. Friend the Member for Stamford and Spalding (Mr. Davies) said about the importance of the amendment. I stress, as my hon. Friend did, the importance to the Bill of the register and the concept of registration. My hon. Friend is right to say that they are central to the Bill.
It is also important to ensure that that registration process is open. There is no point in keeping a register if no one is clear about its purpose or the rules that guide its compilation. It is particularly important that people are aware of the rules that guide who may or may not be included on that register. It is for that reason that I have tabled the amendment, which would amend clause 6(2):
The General Council may make rules in connection with registration and the register and as to the payment of fees
to read: "The General Council shall" and so on.
I am particularly keen that the rules that apply to registration should be made clear to the public as well as to osteopaths, so that a proper assessment can be made of the value of that registration. If, for example, the general council decided, in its wisdom, not to make rules in connection with some of the matters set out in clause 6(3), the value of the registration would be greatly diminished.
The registration procedure will cover a number of matters. For example, clause 6(3)(e) states that the general council may make rules about
the manner in which the Registrar is to satisfy himself as to the physical and mental health of any person applying for registration and the procedure for so doing".
Clause 6(3)(d) provides that the general council may make rules about
the manner in which the Registrar is to satisfy himself as to the good character and competence of any person applying for registration and the procedure for so doing".
Unless people can be satisfied that the registrar has made a proper decision and explored fully the facts behind it, the value of the register will be low.
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I am not happy that the general council's ability to make a discretionary ruling as to what is and what is not to be disclosed should be left unfettered. Perhaps my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) can tell me whether it is proposed that the rules that govern the establishment of the register and its contents will be made public. I am concerned about the use of the word "may", because, as I read it, it is possible under the Bill for those rules to be unrecorded and undisclosed.
I hope that the general council will have to make rules that set out clearly the background against which the register has been compiled. I hope that it will also set out clearly the criteria that will be taken into account by the registrar when he sets up the register. The register should be available to anyone who wishes to read it, so that he is clear as to its value. I hope that my hon. Friend the Member for Cambridgeshire, North-East will be able to assure me on those issues.

Mr. Quentin Davies: I have already paid the compliment to my hon. Friend the Member for Upminster (Sir N. Bonsor) of approving his amendment, even before he had a chance to move it. My hon. Friend has made the essential argument in favour of it, and there is not much that I need to say in support.
When we legislate to give a professional body the power to make rules, it is unsatisfactory if we do not stipulate that that body has the responsibility to make those rules and that, therefore, it must make the appropriate rules. Otherwise, we take away with one hand the responsibility that we have appeared to confer with the other. I set some store by my hon. Friend's amendment, and I agree with what he said about tightening the terms of this crucial clause.

Mr. Moss: My hon. Friend the Member for Upminster (Sir N. Bonsor) may be aware that at least two similar amendments were considered in Committee. My fundamental reason for resisting my hon. Friend's amendment is the same as that which I gave in Committee. Such an amendment would deprive the general council of the responsibility of exercising its own judgment on important matters—for example, the rules connected with registration and the payment of fees.
The Bill is founded on the principle of self-regulation, and it should not render the general council impotent in determining policy and priorities by inflexibly prescribing all its functions in legislation. That would reduce the status of the general council to that of purely an administrative body. The purpose of the Bill is to provide the profession with the statutory framework to enable it to regulate its own activities and chart its future development and growth.
It is worth remembering that the profession itself is seeking the measure. The proposed scheme of statutory regulation will replace the current system of voluntary registration. It is doing so not because, under the voluntary schemes, the profession has failed satisfactorily to register its affairs, but to give it the authority to do more effectively what it has been doing successfully for almost 60 years. Half the members of the general council will be specifically serving the interest of the profession.
Therefore, there is absolutely no basis on which to think that the general council would not make sensible decisions on matters of registration, the payment of fees or other key issues. Furthermore, there is no basis for assuming that such decisions would be detrimental to practitioners. If the profession had any expectation of operating anything but a fair scheme, it would not seek statutory regulation.
My hon. Friend the Member for Upminster asked whether the rules would be made public. I am most happy to confirm that they will.

Mr. Quentin Davies: I am grateful for my hon. Friend's assurance, as the issue of the rules being made public is important for the transparency and the public confidence needed if the new system, envisaged in the Bill, is to work. However, if my hon. Friend can give that clear assurance, why is it not written on the face of the Bill?

Mr. Moss: I was about to come to that matter.
The profession is also looking to submit itself to the authority of the Privy Council. If the Privy Council felt that the general council was failing to perform a function that it should perform, it would be able to intervene and direct the general council as appropriate. In extreme cases, the Privy Council could step in and take over the general council's responsibilities. Since the profession, through the legislation, is placing itself under the scrutiny of the Privy Council, that council will show the way in which matters are proceeding in the public interest by making a statutory instrument which is in the public domain.
The Bill already provides the necessary safeguards against the concerns of my hon. Friends. It also entrusts to the general council the ability to exercise its judgment in fulfilling its statutory duty to regulate the osteopathic profession.

Sir Nicholas Bonsor: I must confess that my hon. Friend has not wholly satisfied me on why the Bill contains a great divide between what the general council "shall" do—which applies to about half the provisions—and what the general council "may" do—which applies to the other provisions. I am puzzled over the positioning of the dividing line between discretion and ruling. However, I am grateful to my hon. Friend for giving his assurance about the openness of the rules that lie behind regulation. Therefore, in the light of what my hon. Friend has said, I seek leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 6

REGISTRATION: SUPPLEMENTAL PROVISION

Amendment made: No. 3, in page 6, line 9, at end insert—'(m) the meaning of "principal practice" for the purposes of subsection (1).'—[Mr. Moss.]

Clause 8

RESTORATION TO THE REGISTER OF OSTEOPATHS WHO HAVE BEEN STRUCK OFF

Mr. Moss: I beg to move amendment No. 4, in page 7, line 19, leave out 'any' and insert 'an'.

Mr. Deputy Speaker: With this it will be convenient to take the following amendments: No. 14, in clause 14, page 11, line 16, leave out 'reaching' and insert 'having reached'.

No. 16, in clause 23, page 19, line 26 leave out 'or (5)' and insert '(5) or (6)'.

No. 26, in clause 33, page 25, line 36, leave out 'consider' and insert 'considers'.

No. 27, in page 25, line 39, leave out 'themselves' and insert 'itself'.

Mr. Moss: The group of what might first appear to be small drafting amendments contains two matters of substance. Amendment No. 4 is a simple drafting amendment, but amendment No. 14 will ensure that the same criteria would be applied for the recognition of non-United Kingdom qualifications, other than those covered by Community law, as will be used for the recognition of United Kingdom qualifications.
Similar amendments were made in Committee in respect of United Kingdom qualifications, but it seems that this one slipped through the net. The House has already heard that the registration system proposed in the Bill will ultimately centre on whether or not a practitioner holds a recognised qualification, which equips him or her with the education, training and skills required for the safe and competent practice of osteopathy.
Clause 14 provides the mechanism for recognising the qualifications that meet that standard. Provision is made in clause 16 for withdrawing recognition if that standard is no longer met or the institution involved fails to comply with the conditions attached to the continued recognition of its qualifications. I shall say more about the conditions later.
In Committee, I described how the wording
evidence of reaching the required standard of proficiency
was a little too tight, as it demanded that a qualification would have to hit the mark when the application for recognition was being considered. It did not enable a qualification that had previously been met and was meeting the required standard when it was awarded to the osteopath to be recognised if it no longer met the standard or was, perhaps, no longer being awarded. The amendment will extend the same flexibility as is now provided for United Kingdom qualifications to non-United Kingdom qualifications.
Decisions on whether a qualification provides evidence that someone had reached the required standard of proficiency laid down by the general council under clause 13 for the safe and competent practice of ostoepaths—and so should be recognised for the purposes of registration —will initially be made by the education committee. If it

is satisfied that the qualification provides such evidence, it will recommend to the general council that the qualification should be a recognised qualification.
In keeping with the practice adopted by schemes governing other health care professions that operate a similar system of recognition, the general council will seek the approval of the Privy Council for the qualification to be recognised. To assist the education committee in that task, clause 12 enables the committee to appoint visitors, who are almost certain to constitute the principal means by which the education committee obtains information on the nature and quality of instruction given by an institution. In turn, that will provide the basis on which the committee can recommend to the general council whether a qualification should be recognised.
While it is envisaged that judgment on the adequacy of overseas qualifications would normally be made on the basis of information supplied by the institution rather than by means of an overseas visit, clause 12 was amended in Committee to remove the previous limitation restricting the scope of those visits to those institutions in the United Kingdom.
Amendment No. 16 provides an osteopath making an application to the health committee for a conditions of practice or suspension order, made under clause 23, to be reviewed, with the right to a hearing. As we have already discussed this morning, the health committee will form an important part of the statutory scheme's fitness-to-practise machinery. Its function is to investigate allegations made against an osteopath that his or her ability to practise is seriously impaired because of physical or mental health and consequently poses a threat to the safety and well-being of his or her patients.
Unlike its sister committee, the professional conduct committee, the health committee's role is not disciplinary. Instead, it ensures that proper and adequate safeguards are provided for patients. For that reason, the health committee will be required to ensure that any action that it takes in terms of suspending an osteopath's registration or imposing conditions on his or her continued practice has to be proportional to the risk that he or she is considered to represent to his or her patients. As the committee's function is not disciplinary, it will have no powers of erasure.
The Bill also makes provision to ensure that the osteopath is provided with the full details of the allegation made against him or her and given the opportunity to state his or her case at a hearing at which he or her—sorry, he or she—may be legally represented if he or she should so chooses. I think that I shall just stick to "he" as it will be more simple—although I may be picked up by my hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland).

Sir Nicholas Bonsor: My hon. Friend will note that, despite the best efforts of the feminists, "he" still includes "she" for the purposes of legal definition.

Mr. Moss: I am extremely grateful to my hon. Friend for his direction.

Lady Olga Maitland: May I reassure my hon. Friend that I have no feminist angst about the use of "he" or "she"? I do not believe in butchering the English language, and think that it is appropriate at times to use the generic term. "He" will suffice very nicely here.

Mr. Moss: The Bill also makes provision to ensure that the osteopath is provided with full details of the allegation against him and is given an opportunity to state his case at a hearing, at which he may be legally represented if he so chooses, as well as the right of appeal to the appeal tribunal against decisions of the health committee. The Bill also provides an opportunity for the osteopath to make an application to the health committee once a year for the order made against him to be reviewed. As drafted, the Bill does not provide the osteopath with an opportunity to put his case at a hearing before the health committee comes to a decision on such an application.
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It has never been our intention to deprive the osteopath of this opportunity. Such an intention would run contrary to the spirit of natural justice, one of the key principles on which the scheme is to be founded. The amendment therefore extends the practitioner' rights to a hearing to include such applications, thereby ensuring that the workings of the health committee will be open and fair, in theory and in practice.

Mr. Quentin Davies: Before my hon. Friend leaves the subject, will he give the House some examples of the sort of offences for which he considers removal from the register appropriate? Does he believe that it is the likely intention of the council—I say "likely", because it does not yet exist—to incorporate the sort of moral and non-clinical offences that the BMA has in the past considered grounds for disbarring doctors?

Mr. Moss: We are talking about the health committee at the moment. I have already said that it is not a disciplinary body—it has no powers of erasure from the register. The other "fitness to practise" committees, particularly the professional conduct committee, have powers to erase from the register if, at a hearing, an osteopath is found to have broken the rules. He can therefore be removed from the register. He can reapply at some stage in the future, but conditions may he set governing the standards of proficiency that he needs to meet to re-enter the register.
Amendments Nos. 26 and 27 provide me with an opportunity to remind the House of the important role that the Privy Council will play in the operation of the statutory scheme. In keeping with the other statutory schemes governing health professions, the work of the General Osteopathic Council and its four statutory committees will be overseen by the Privy Council. One of the Privy Council's key functions will be to approve the rules drawn up by the general council.
These rules will cover the entire range of the general council's responsibilities, including registration, post-registration training and the procedural rules of the four statutory committees. When we come to look at the schedule, especially the provisions for establishing the first General Osteopathic Council, we shall see other ways in which the Privy Council will be involved in the scheme.
Clause 33 provides for the Privy Council to be granted default powers to enable it to direct the General Osteopathic Council to perform any function under the Act that the Privy Council considers the general council should have done but has failed to do. If the general council refused to respond to this direction, the Privy

Council would he empowered to step in and take over the functions of the general council and do anything that the latter could have done under the Act.
The Privy Council possesses default powers similar to those under the statutory schemes of other health professions. To set these key provisions in context, I should add that there are no known cases of the Privy Council having had to exercise its default powers in relation to a statutory scheme. Although the osteopaths can take pride in being first in respect of a number of new ideas in the area of statutory regulation, I am confident that this is one first which they have no intention of trying to achieve.

Mr. John Bowis: I do not intend to enter the discussion of "he" and "she". I am happy to accept the learned definition offered by my hon. Friend the Member for Upminster (Sir N. Bonsor). I have always believed that "she who must be obeyed" goes back to Rider Haggard, reiterated by Bernard Shaw in "Getting Married"—but for today we will stick to the legal definition.
I want to ask for some reassurance and, I hope, support from my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss). Unlike my hon. Friend the Member for Stamford and Spalding (Mr. Davies), I have no parental examples to offer, but some of my constituents are training to become osteopaths, and they have asked me about the recognition of qualifications with particular reference to training grants.
The British School of Osteopathy, which I imagine offers the sort of qualifications to which the amendments refer, attracts students from around the country. Those students receive grants from local education authorities, but not full grants. The fees alone are about £5,000, but my constituents get grants of between £600 and £700, leaving them a great deal of money to find so that they can qualify and met the high standards which the Bill rightly seeks to establish.
I hope that my hon. Friend has managed to obtain reassurances from the Government on this score. The issue partly comes under the responsibilities of the Department for Education and certain other Departments of State. I hope that my hon. Friend will join me in pressing for recognition of such qualifications for eligibility for full and mandatory grants. I hope that these courses will be recognised under the new law and that mandatory awards will be given for them.

Lady Olga Maitland: I support this group of amendments and I wish to draw attention to the importance of ensuring that overseas applicants to join the osteopathic profession maintain our standards of professionalism. It has become abundantly evident that there is a wide variation in training standards. A properly qualified osteopath has to undergo four years' training, which hardly compares with the gentleman who decides to set himself up with no experience but with a sign outside the door. We do not want to return to the days when a dentist's sole claim to expertise rested on the fact that he pulled teeth.
Professional standards are important. Those with overseas experience may well reach our standards, but we need to be certain that they conform to the rigorous criteria to be imposed by the newly formed osteopathic governing bodies.

Sir Nicholas Bonsor: I endorse the remarks of my hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland). I myself tabled an amendment which was not selected but which had to do with practitioners' ability to speak our native language. [Interruption.] I hear some tut-tutting from the Labour Front Bench. It is astonishing that the Labour party should wish to put into our medical profession people who cannot communicate properly with our patients. It is amazing that such crass stupidity can form part of Labour party policy—

Ms Primarolo: If the hon. Gentleman has read the Bill he will know that it contains regulations and conditions which apply to osteopaths the same standards of education and training as are applied to all the medical professions in this country. So his comments about communicating in the same language are misplaced and irrelevant to the debate. That is why I tut-tutted.

Sir Nicholas Bonsor: I am sorry that I gave way—

Mr. Deputy Speaker: Order. The hon. Gentleman's amendment was ruled out of order, so he cannot now speak to it.

Sir Nicholas Bonsor: I would not dream of speaking to my amendment, Mr. Deputy Speaker. I was merely enlarging on my hon. Friend's remarks about practitioners' general qualifications. And it is certainly a matter of great concern that many people who practise medicine in this country cannot communicate with their patients. The Government should turn their attention to that.

Lady Olga Maitland: Does my hon. Friend agree that fluent English is vital for the successful outcome of treatment and that misunderstandings often arise because of poor communication between practitioner and patient?

Sir Nicholas Bonsor: I whole-heartedly agree. No one can prescribe the right treatment if he cannot understand what the patient is telling him about his ailment. As my hon. Friend says, it is regrettable that all too often that is the case. I hope that the Bill will contain some provision to control standards of education in the profession.
Unless I have misunderstood the Bill, the method of getting to a disciplinary hearing seems rather clumsy. Clause 23 says that the health committee shall take certain action on allegations referred to it under section 20. Section 20 sets out the allegations which will lead to disciplinary action by the general council. It states:
This section applies where any allegation is made against a registered osteopath to the effect that—

(a) he has been guilty of conduct which falls short of the standard required by a registered osteopath;
(b) he has been guilty of professional incompetence;
(c) he has been convicted (at any time) in the United Kingdom of a criminal offence".
I am glad to say that elsewhere in the Bill that is limited to a relevant criminal offence.
A complaint under those headings may be made not to the investigations committee or to the professional conduct committee, but to the health committee. According to clause 23, the health committee can then take certain actions including the possible suspension of the osteopath, and I presume that it would then refer the matter to the investigations committee or the professional conduct committee for action. I am puzzled about why such a roundabout route should be adopted and why allegations under section 20 should not be made directly to those who will deal with them.

Mr. Moss: My hon. Friend the Member for Battersea (Mr. Bowis) asked about student funding. I understand that in the past the profession made continuous representations about the sort of student funding that my hon. Friend mentions. Unfortunately, to date the answer has been a firm no. However, more recent approaches have elicited a different response and the profession has been told that if it regulates itself under some sort of statutory regime its request will be viewed more favourably.
The osteopaths have organised and pressed for a statutory regulation system. I wish them every success, when that has been achieved, in approaching the Department for proper funding for students, many of whom follow four-year degree courses. One of the colleges was mentioned by my hon. Friend the Member for Battersea, but there are others. The level of qualification is high and every encouragement should be given by the system to enable more and more students to qualify at the highest level.
My hon. Friend the Member for Upminster (Sir N. Bonsor) spoke about the tortuous route for complaints. Allegations about health matters can be made by patients or by a fellow professional. The personal problem of the osteopath's health may have a bearing on whether he can carry out his job to the required level.

Sir Nicholas Bonsor: Section 20 lists other less personal and perhaps equally significant matters which bear on whether the osteopath can properly practise. A conviction for a criminal offence is mentioned, and I do not see why that should go through the health committee.

Mr. Moss: I do not think that it does. Clause 20 requires only allegations about an osteopath's health to be referred to the health committee. Other allegations will not be directed along that route. The investigations committee acts to ensure that there is a case to answer and that the health committee is not being asked to look at cases that are outside its powers.

Amendment agreed to.

Clause 9

ACCESS TO THE REGISTER ETC

Mr. Moss: I beg to move, amendment No. 5, in page 7, line 36, leave out subsection (2) and insert—
'(2) Any person who asks the General Council for a copy of the most recently published register shall be entitled to have one on payment of such reasonable fee as the Council may determine.
(2A) Subsection (2) shall not be taken as preventing the General Council from providing copies of the register free of charge whenever it considers it appropriate.'.
The amendment will enable the general council to make copies of the register available free of charge when it considers that appropriate. Although the existing wording of the clause might have been sufficient to enable the general council to do that, some doubt may have existed because of an amendment in Committee to clause 19 which concerns the code of practice that the general council will be required to prepare and publish. That amendment was made specifically to ensure that the general council could provide copies of the code free of charge.
Taking one's own Bill through Parliament certainly opens one's eyes to the finer points of legislation and especially to the nuances of drafting. Because the Bill is


now quite specific in enabling the general council to make the code of practice available free of charge, it could have been argued that because the subsection on the register was not as clear as intended it would not give the general council the same freedom in respect of the register. That is certainly not our intention. I made it clear during the clause stand part debate in Committee that the intention was for the general council to have this discretion. I said that the clause imposed a duty on the general council to publish a copy of the register annually and to make copies available for sale or distribution free of charge as it thinks fit.
The amendment removes any doubt and will give to the general council the statutory freedom that had always been intended.

Amendment agreed to.

Clause 10

FRAUD OR ERROR IN RELATION TO REGISTRATION

Mr. Moss: I beg to move amendment No. 6, in page 8, line 6, leave out from 'The' to 'at', in line 12, and insert—
'Registrar shall investigate any allegation that an entry in the register has been fraudulently procured or incorrectly made and report on the result of his investigation to the General Council.
(1A) An entry which has been restored to the register under section 6(5) or 8, or under rules made by virtue of section 8(8), may be treated for the purposes of this section as having been fraudulently procured or incorrectly made if any previous entry from which the restored entry is derived was fraudulently procured or incorrectly made.
(2) The Registrar may'.

Mr. Deputy Speaker: With this we may consider the following amendments: No. 7, in page 8, line 13, leave out 'to'.

No. 8, in page 8, line 16, leave out from beginning to end of line 17 and insert—
The General Council shall by rules make provision, in relation to any case where the Registrar proposes to suspend an osteopath's registration under subsection (2)—'.

No. 9, in page 8, line 23, leave out 'on the matter'.

No. 10, in page 8, line 24, leave out
'an entry in the register'
and insert 'the entry in question'.

No. 11, in page 8, line 38, leave out 'may appear as' and insert 'shall be'.

No. 12, in page 9, line 3, leave out subsection (11).

No. 13, in page 9, line 5, at end insert—
'() The General Council may by rules make such further provision as it considers appropriate with respect to suspensions under subsection (2), including in particular provision as to their duration.'.

Mr. Moss: The amendments seek to streamline the provisions of clause 10. They will do that by giving the registrar the direct power and responsibility to investigate an allegation that an entry in the register has been incorrectly made or fraudulently obtained. As drafted, the Bill provides for such power and responsiblity to be conferred on the general council, with an ability for the council to make laws for these to be exercised by the registrar.
This is an important change, but it is consistent with other themes in the Bill. For example, it will be the registrar who will be charged under clause 2 with the statutory duty of establishing and maintaining the register of osteopaths. Therefore, it would not be unreasonable for

the registrar to be able to initiate action to be satisfied about the correctness of the entries in the register. The amendments will achieve that purpose.
The resulting change should also mean that any investigation will be carried out far more speedily, as the registrar will be able to carry out an immediate investigation into such an allegation without having to wait for the general council to meet and consider the matter first. That would avoid any unnecessary delay which might have arisen if the general council's periodic meetings turn out to be fairly infrequent.
When the registrar has completed his investigation, he is to report on the matter to the general council. If, having considered the registrar's report, the general council is satisfied that the entry in question has been incorrectly made or fraudulently obtained, it may order the registrar to remove it. The osteopath would have a right of appeal against that decision to the Judicial Committee of the Privy Council.
As part of the package, the registrar would have the authority to order the immediate suspension of an osteopath's registration, pending investigation, where he is satisfied that such action is necessary to protect members of the public. That would place the registrar of the General Osteopathic Council in a unique position vis-a-vis the registrars of similar schemes for health care professionals.
The House will see, however, that the registrar is not given a completely free hand to cut a swathe through the names of the osteopaths appearing in the register. He will be permitted to take that action only when he is satisfied that it is justified in terms of protecting the public. His powers will also be contained within the limits prescribed by the rules to ensure that, in instances where he proposes to exercise his powers—which must, by definition, be before he imposes such an order—the practitioner in question will be given an opportunity to appear in front of the investigating committee supported by legal representation, if he so chooses, to argue his case against suspension.
That is an important provision. In ensuring that the statutory scheme provides protection for the public, it is also important to ensure that the human rights of the osteopath are protected. In that way, the public and the profession will be able to have the utmost confidence in the scheme.
It may at first sight seem a little odd for the practitioners' objections to the making of a suspension order to be heard by the investigating committee. The reason for this decision is that the investigating committee will already have in place the machinery, set out in clause 21, to hold such hearings. The registrar is required to report the outcome of his investigations to the general council. If, having considered his report, the general council is satisfied that any entry in the register has been incorrectly made or fraudulently obtained, it may order the registrar to remove it.
The osteopath has a right of appeal to the Judicial Committee of the Privy Council against a decision to remove his name from the register. Such hearings would normally be adversarial. As drafted, the Bill provides only that the general council may appear as respondent. In keeping with what I said earlier, we now feel that the general council ought always to be the respondent, if only for this simple reason: if it is not, who is?
By making the general council a respondent, the provisions in clause 10(11) relating to the apportioning of costs are not required. The general council would


automatically be a party to the hearing and could, therefore, be liable to incur the costs of the parties. The amendments, and the clause, further strengthen the status of the statutory register. The provisions also ensure that they apply to an entry that has been restored to the register by virtue of clause 6(5)—which enables an osteopath who has failed to renew his registration under clause 8, which deals with the registering of an osteopath who has been struck of—if the original entry was incorrectly made or fraudulently obtained.

Lady Olga Maitland: I support the amendments. It is important that the public have a right to be protected from fraudulent entries that have got on to the register. It is also important that we should take into account all the different kinds of abuses of the profession that might be perpetrated. I take it that this refers to criminal offences, to fraud and to the breakdown of discipline between the osteopath and the patient, particularly when that discipline is a matter of trust and that trust has been abused, especially through very personal relationships. When all those factors are taken into account, and we bear in mind the worthless qualifications that can be used, it is essential that the House should agree to the amendments.

Mr. Bowis: The amendments incoprporate the Upminster doctrine by removing a "may" and inserting a "shall". No doubt my hon. Friend the Member for Upminster (Sir N. Bonsor) will welcome that. I am sure that he is right in that case. I am equally certain that the amendment, which tightens that process up, is correct. If we are to have a properly regulated profession, there must be no question of anyone being able fraudulently to get on to the list, which the public ought to come to trust. That is particularly the case if the fraud applies to any claims of professional qualifications, quite apart from any criminal offences that are deemed to be relevant.
However, I seek the reassurance of my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on the other side of the coin. It is possible that the clause will provide opportunities for those who have professional jealousies to make frivolous or mischievous claims against a properly qualified person. I am sure that the procedures will ensure that such claims are dismissed, but I seek my hon. Friend's assurance that speed will be of the essence, because somebody's career and professional standing could be at risk if such a claim were made against him by a professional rival.
The clause does not contain a speed element. I hope that there will be a quick look at each case by the registrar to see whether it should be considered further—a sort of procurator fiscal look at the case. If there is a case to be answered, it should be investigated fully and properly. However, that initial speed is necessary.

Mr. Quentin Davies: I have some doubts about the circumstances in which the registrar would intervene, as set out in the clause and the amendments to it. Some of the circumstances are defined in clause 20, which speaks of
conduct which falls short of the standard required of a registered osteopath".
However, as far as I can see from reading through the Bill, such conduct is nowhere defined. In other words, there is an extraordinarily wide area in which the registrar could say that the osteopath had been guilty of conduct falling

below the required standard. Could my hon. Friend give us some illustrations as to what conduct that might be? For example, would it include allegations about drunkenness or sexual misconduct? What does my hon. Friend envisage are standards of conduct, not involving a relevant criminal offence, that would require a registrar to suspend an osteopath?

Mr. Moss: The comments by my hon. Friend the Member for Battersea (Mr. Bowis) go to the heart of the amendments. We have tabled them in an attempt to streamline the process set out in clause 10. He may feel that, because we have not set a time limit in law, we have not gone far enough, but I assure him that the purpose of the amendments is to make sure that any allegation of the kind that he talked about, certainly those involving an entry on the register, can be picked up immediately by the registrar and acted on, rather than those involved having to wait, perhaps for a meeting of the general council to come round, before the process of investigation can be activated. We put the registrar at the heart of the preliminary look at what is, after all, a key element of the Bill—the accuracy of the entry in the register.

Sir Nicholas Bonsor: I take my hon. Friend's point about the investigation by the registrar and about increasing the speed with which such allegations can be dealt with. I welcome the change that the amendment will make. However, will he readdress the question that I put to him a little earlier about the health committee? I have now read clause 20 carefully. Nothing in it suggests that only serious impairment of the ability to practise as an osteopath because of a physical and mental condition should lead to a referral to the health committee. Anything under section 20 can be referred to the health committee and that goes against the desire to speed up investigations.

Mr. Moss: I shall first answer the question put by my hon. Friend the Member for Stamford and Spalding (Mr. Davies), who asked about misconduct that would necessarily result in referral to one of the committees. We are dealing with amendments to clause 10, which relates only to entries fraudulently obtained and not to disciplinary offences, which come under clause 20, to which my hon. Friend the Member for Upminster (Sir N. Bonsor) referred. Clause 20(12) says:
Where the Investigating Committee concludes that there is a case to answer, it shall …

(b) refer the allegation as formulated by the investigating Committee—

(i) to the Health Committee, in the case of an allegation of a kind mentioned in subsection (1)(d)".
Therefore, it is extremely specific on what can be referred to the health committee.

11 am

Sir Nicholas Bonsor: Unless I have grossly mistaken the position, there is nothing in clause 20 to prevent a person from making an allegation directly to the health committee. I do not think that the clause relates only to matters that have already been before the investigating committee. As I read it, it is for the health committee to decide whether to refer a case to the investigating committee, not vice versa. Subsection (3) states:
Where an allegation is made to the General Council, or to any of its committees (other than the Investigating Committee), it shall be the duty of the … committee to refer the allegation to the Investigating Committee.


The clause to which my hon. Friend referred in fact relates to what happens at a later stage, when the investigating committee has a matter referred to it by the health committee.

Mr. Moss: I take my hon. Friend's point. Initially, a case would be refered to the investigating committee, which would then decide under clause 20(12)(b)(i) whether it is a matter specific to the health committee under clause 20(1)(d). If it is, it will send the case to the health committee for further inquiry.

Mr. Quentin Davies: I want to challenge the interpretation that my hon. Friend put on my last question to him. He said that clause 10 provides for the registrar to suspend an osteopath if evidence is produced showing that a registration has been fraudulently procured or incorrectly made. Subsection (2) provides for the registrar
to have power, at any time during his investigation, to suspend the registration in question if he is satisfied that it is necessary to do so in order to protect members of the public.
The registrar will have wide powers. If it were alleged that a registration was improperly made, he would have the power to anticipate the decision of the general council or its committees and suspend that registration.
Does the registrar have to give specific grounds for such a suspension? Does he have to define in what way he feels the public are endangered? From my reading of the clause, that does not appear to be the case. Should he incorrectly suspend an osteopath and subsequently discover that the registration was valid, and therefore the suspension should not have been made, is there any provision for compensation for the osteopath concerned? After all, he could have lost considerable revenue during his suspension, which was based on a mistaken decision by the registrar.

Mr. Moss: The title of clause 10 refers to
Fraud or error in relation to registration.
Although subsection (2) provides the registrar with power to suspend, he would not do that unless there were very strong grounds for suspecting that there had been a fraudulent entry.
There is no provision for compensation, but there are many checks and balances in the Bill to ensure that accusations filter through the system in a way that gives the osteopath every opportunity to make his case. Of course, very often he is backed by legal advice.

Mr. Quentin Davies: My hon. Friend says—and I have no reason to doubt him—that the registrar would be extremely careful before using the powers under the clause. However, subsection (2) is so widely drawn that we have to place confidence in the good sense and integrity of the registrar. His powers are not limited during the investigation. He could take a purely arbitrary decsion to suspend if he so wished.

Mr. Moss: I have nothing further to add to that point.

Sir Nicholas Bonsor: I am sorry to pester my hon. Friend, but it is important to clarify the issues surrounding clauses 20 and 23. We need to be absolutely clear about what clause 23 means; I do not think that that is clear at the moment. It would make the meaning absolutely clear if subsection (1), line 2, were amended to read "under section 20(12)". That would make the position what my hon. Friend has stated it to be, rather than as I originally perceived it to be.
The provisions of clause 23 would then apply only to any matters referred to the health committee by the investigating committee, rather than the alternative interpretation which currently could be thought to mean that any allegation under clause 20(1) should be dealt with by the health committee.
I do not ask my hon. Friend for an immediate answer to my suggestion, but I should be grateful if he would consider it.

Mr. Moss: I am grateful to my hon. Friend.
My hon. Friend the Member for Stamford and Spalding (Mr. Davies) said that clause 10(2) provided wide-ranging powers for the registrar. However, subsection (3) makes provision for the osteopath to appear before the investigating committee to state his case before an order is made.

Amendment agreed to.

Amendments made: No. 7, in page 8, line 13, leave out 'to'.

No. 8, in page 8, line 16, leave out from beginning to end of line 17 and insert—
'() The General Council shall by rules make provision, in relation to any case where the Registrar proposes to suspend an osteopath's registration under subsection (2)—'.

No. 9, in page 8, line 23, leave out 'on the matter'.

No. 10, in page 8, line 24, leave out
'an entry in the register'
and insert 'the entry in question'.

No. 11, in page 8, line 38, leave out 'may appear as' and insert 'shall be'.

No. 12, in page 9, line 3, leave out subsection (11).

No. 13, in page 9, line 5, at end insert—
'() The General Council may by rules make such further provision as it considers appropriate with respect to suspensions under subsection (2), including in particular provision as to their duration.'.—[Mr. Moss.]

Clause 14

RECOGNITION OF QUALIFICATION

Amendment made: No. 14, in page 11, line 16, leave out 'reaching' and insert 'having reached'.—[Mr. Moss.]

Clause 15

RECOGNITION OF QUALIFICATIONS: SUPPLEMENTAL

Mr. Moss: I beg to move amendment No. 15, in page 12, line 29, at end insert—
'() The General Council shall not exercise any of its functions under subsection (4) or (5) without the approval of the Privy Council.'.
The purpose of the amendment is to provide that the general council can exercise its powers to impose or remove conditions on the continued recognition of a qualification, with the approval of the Privy Council. The ability to impose conditions on the continued recognition of a qualification will be one of the tools in the general council's kitbag to ensure that high standards of education are achieved and maintained.
The sort of conditions that the general council could apply will be wide and varied, for example, when a new course is getting off the ground. One of the amendments made in Committee to clause 14 gives the general council, with the approval of the Privy Council, the ability to recognise a qualification prospectively. That would be on the basis that the information available at the time to the


education committee and the general council was sufficient to demonstrate that when the qualification was eventually awarded, it would reach a standard of proficiency required by the general council for the safe and competent practice of osteopathy.
That was an important amendment to make, because before it was incorporated into the Bill only qualifications presented to the general council could be considered for recognition. In the case of a new course, there would have been no qualification until the first cohort of students had graduated. However, unless there were the certainty that the qualification would be recognised, it is doubtful whether anyone would enrol for the course.
Granting recognition to an as yet non-existent qualification on the basis that when it eventually came to be awarded there was likely to be evidence of it having reached the desired standard could be regarded by some as akin to signing a blank cheque. Although the general council would be able to initiate action to withdraw recognition once the qualification was awarded, that would be an extreme step taken too late to help students. The ability to impose conditions covers that middle ground. The amended provisions mean that the education committee can check that the course is developing as planned and provide it with the necessary levers to encourage the institution concerned to take remedial action if things go awry.
However, it will not be only in the case of new qualifications that the general council will be likely to want to impose conditions. Indeed, there may be general standards that the general council will wish to apply to the continued recognition of all recognised qualifications. These might include the ability of the education committee to appoint external examiners, to participate in the final clinical examinations or to require an institution to provide the education committee with, say, an annual report.
The ability to impose conditions will provide the education committee with very powerful levers to ensure that high standards of education are achieved and maintained. Failure to comply would be sufficient for the education committee and the general council to begin taking steps to withdraw recognition from the qualification.
Clause 15 requires that any conditions are to be imposed at the time that a qualification is granted recognition and for the institution concerned to be notified of their imposition as soon as possible. This, therefore, makes them part and parcel of the recognition process. Given that clause 14 provides for the recognition of a qualification to require the approval of the Privy Council, it would seem appropriate that any conditions imposed under clause 15 should similarly be subject to the Privy Council's approval. That is what the amendment will achieve. It will also place the general council's power under subsection (5) to remove conditions under the same regime.

Mr. Quentin Davies: The recognition of qualifications is crucial to the credibility of the register and, therefore, of the osteopathic profession. My hon. Friend mentioned a number of issues that arise in this context, including the prospective recognition of such qualifications which it

seems to be necessary to accommodate, for the reasons that he mentioned. However, may I ask my hon. Friend to explain the international context of the amendment.
Under freedom of establishment, would osteopaths from the continent be able to establish themselves here? Is it envisaged that the education committee would recognise continental qualifications and thereby allow those who have graduated in osteopathy in continental centres of education and who call themselves osteopaths to be part of the register in this country, whether they practise here or on the continent, and to use their presence on the register and the recognition of their qualifications by the general council as the basis for the professional credibility as osteopaths elsewhere in the European Community? This is an important dimension to the issue of recognition of qualifications which is not dealt with specifically on the face of the Bill or in my hon. Friend's amendments to the clause. It ought to be dealt with before the House allows the Bill to proceed.

Mr. Sackville: The Government support the amendment. The use of a recognised qualification as providing the principal means whereby practitioners are entitled to be registered is a key feature of all other health care statutory schemes. Just as entry on to the register will be the prize sought by practitioners, obtaining recognition of their qualification will be the accolade sought by education institutions. It will be a key factor in determining the reputation of the institution. It will be the principal means by which it will be able to attract students and help to ensure its future viability. Simply put, it will make or break an institution. It is therefore vital that the institutions concerned can be assured of the fairness by which the system of recognition will operate.
When my hon. Friend described the process at Second Reading, he emphasised that the requirement on the general council to secure the approval of the Privy Council before a qualification is afforded recognition would ensure that all such decisions would be impartial, but the provisions for fair play in the Bill go beyond that. Under clause 14, the general council would be required to maintain and publish a list of the recognised qualifications. That will provide an open system and will enable one institution to compare its standards with another.
Clause 14 also provides for the general council to require the education committee to publish a statement on the criteria that it will use when advising the general council on whether a qualification should be recognised. That will provide education institutions with a level playing field and ensure that they are fully aware of the standards for which they must aim.
Clause 15 would place the general council under an obligation to notify an institution of the outcome of its application to have its qualification recognised as quickly as possible. It would also require the general council to give full reasons for its decision, in cases where it decided not to grant recognition.
These assurances could, however, be weakened if the general council's ability to impose conditions on the continued recognition of a qualification remained unchecked. Institutions may be alarmed at the admittedly extreme prospect of having burdensome conditions imposed, or of their being perversely applied in cases where the general council did not want to grant


recognition but could find no reason for not doing so, in order to use them as the means by which to seek to withdraw recognition on the ground of failure to comply.
The amendment would remove any such anxieties. Collectively, the provisions for recognising qualifications will give the firm foundation on which the osteopath scheme will be built and will provide the necessary building blocks to ensure that, in future, osteopaths are fully trained and properly qualified to practise osteopathy. For all those reasons, the Government support the amendment.

Lady Olga Maitland: I support the amendment. It is vital that the general council should ensure the highest standards of training. It is important to ensure that a battleground does not develop between the general council and the institutions. I hope that the institutions will develop training programmes of such quality that by the time their students graduate, they will have achieved the rigorous standards demanded by the general council.

Mr. Moss: My hon. Friend the Member for Stamford and Spalding (Mr. Davies) asked about European Community regulations and laws. If he refers to page 12, he will see that subsections (10) and (11) of clause 14 deal with that matter.

Amendment agreed to.

Clause 22

CONSIDERATION OF ALLEGATIONS BY THE PROFESSIONAL CONDUCT COMMITTEE

Mr. Moss: I beg to move amendment No. 59, in page 17, line 24, after 'section', insert
'or by virtue of a recommendation under section 30(7)(c)'.

Mr. Deputy Speaker: With this, it will be convenient to consider the following amendments: No. 60, in page 17, line 39, after 'section', insert
'or by virtue of a recommendation under section 30(7)(c)'.

No. 61, in page 18, line 42, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c).'

No. 62, in clause 23, page 19, line 2, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c)'.

No. 63, in clause 23 page 19, line 12, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c)'.

Mr. Moss: Clauses 22 and 23 empower the professional conduct committee and the health committee to make a conditions of practise order, or a suspension order in cases where they consider that an allegation made against an osteopath to be well founded. They also enable each committee to review an order while it is still current and to consider whether it should be renewed or, within certain limits, replaced by a different order, or otherwise modified or even revoked.
The wording of each clause, however, is tightly drafted. In each case, it limits the committee's powers of review to orders, in the case of the professional conduct committee,

made under clause 22 and, in the case of the health committee, to those made under clause 23. Under normal circumstances, that is unlikely to create any difficulty. However, in cases where an appeal had been made—for example, to the appeal tribunal against a decision of the health committee—the order in force would not, strictly speaking, be one made under clause 23 but under what is currently new clause 3. The same point would also apply to orders made on appeal to Her Majesty in Council under clause 30.
The question has been raised, therefore, whether the professional conduct committee and the health committee would have the power to review orders made on appeal under the provisions of another clause as to the way that they could review those that they had made. They ought to have that power. It was always our intention that they should have that power.
The amendments, therefore, remove any uncertainty about the position by including a reference to those orders made on appeal under the provisions of other specific clauses.

Mr. Quentin Davies: Will my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) consider carefully a point that is not covered by the amendments? I have referred to equity for those who are accused of an offence. They may be accused of having obtained their registration improperly or fraudulently, they may be accused of having subsequently committed a criminal offence or they may be accused of having subsequently been guilty of professional misconduct. The procedures set out in clause 22, in clause 10 and in clause 21 would then begin, depending on which particular 'committee was handling the case.
My hon. Friend has told the House that the Bill does not provide for compensation if a practitioner is suspended and it is then found that there is no ground for his suspension. There may have been no merit in the complaint, but the practitioner may have lost considerably in the meantime. It is unsatisfactory that there should be no time frame within which the procedures set out in clause 22 must be completed. It would be possible for the registrar under clause 10 and for the professional conduct committee under clause 22 to take any amount of time to consider such matters.
The process could go on for weeks, for months or for years. Even if the practitioner against whom the procedure was initiated were wholly guiltless, he might have been deprived of the right to practise his profession in the interim, possibly for years, and he might never be able to resume his profession although it had been found that there was no substance in the original complaints against him.
My hon. Friend the Member for Cambridgeshire, North-East has said several times that he intends that the quasi-judicial disciplinary procedures in the Bill should observe the principles of natural justice. I know that my hon. Friend is sincere in that intention and that there are many reflections of that principle in the Bill. Will he reflect on the point that there is an important dimension of which the Bill does not take account? If the amendment is agreed to, the Bill, for the best possible motives and in the highest-minded fashion, will have laid the basis for some appalling miscarriages of justice, not because the procedures will not be observed and not because the


people who are involved in the committees intend that there should be any injustice, but simply because investigations will drag on.
The main priority of practising osteopaths will not be to spend time on the professional conduct committee. There will always be the temptation to suspend investigations because of Christmas or Easter. The procedure will drag on and a wholly innocent osteopath who has had an appalling cloud over him for a long time—he may have been suspended by the registrar under clause 10 and he will not have been able to practise in the interim—will lose a lot of money. There will be no redress for the consequential loss of income.
The osteopath will find that he cannot refer to the Bill and say, "Look, the procedures laid down have a time scale attached to them, so I insist that justice is done and that the matter is brought to a conclusion one way or another within that time scale." The absence of a time scale is in conflict with my hon. Friend's laudable intention that justice should be done and that those who are subsequently proved to be completely blameless and against whom unjustified complaints have been made are not damaged.

Sir Nicholas Bonsor: I entirely agree with my hon. Friend the Member for Stamford and Spalding (Mr. Davies). I served on the investigations committee of the Lloyd's council for two or three years and I am well aware how long investigations can drag on despite the best intentions of all involved to make them as speedy as possible. In addition to the difficulties mentioned by my hon. Friend, there is the substantial difficulty of obtaining evidence from all the witnesses who may wish to give evidence, of finding out who they are and of ensuring that they have an opportunity to present their case to the investigations committee. These things tend to take a great deal of time and unless substantial incentives or penalties are attached—I share my hon. Friend's concern—people could be grossly out of pocket and badly treated by an investigation into a complaint that ultimately proved groundless or ultimately proved to have been started maliciously by someone who had some reason to wish the practitioner concerned ill.

Mr. Quentin Davies: I am grateful for my hon. Friend's support. Does he agree that there is an inter-relationship between compensation for loss of revenue as a result of a complaint that is subsequently deemed to have been quite unjustified and uncalled for—because the practitioner had committed no offence and because there was no impropriety in the way in which he was registered—and the time scale, to which we attach great importance? If there was provision for compensation, the osteopath who was suspended would find that his claim for compensation would increase with the time taken by the investigation because he would lose more patients and more revenue. The bill would clock up. Would that not act as a major inducement for those carrying out the investigation on behalf of the general council, whether the registrar and his staff or the members serving on the professional conduct committee, to get on with the investigation and to ensure that there were no unreasonable delays in the investigations and the conclusions?

Sir Nicholas Bonsor: I am grateful to my hon. Friend for expanding on the theme. He is absolutely right to say that a provision should be inserted to safeguard the interests of the osteopaths.

Lady Olga Maitland: Could my hon. Friend draw a parallel with any other professional body and with how it deals with the problem? The General Medical Council might be one such example.

Sir Nicholas Bonsor: I am afraid that my hon. Friend has asked the wrong person. That question could be addressed to my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) or to the Minister. I cannot draw a parallel with the General Medical Council because I am not sure how it deals with this problem.

Ms Primarolo: Exactly.

Sir Nicholas Bonsor: The hon. Lady says, "Exactly". None the less, the point remains a matter of concern. My hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland) has asked a valuable question and I hope that we shall be given an answer by someone who is able to do so.
My detailed concern relates to the consequence of agreeing to the amendment. Under clause 30, which deals with appeals against the decisions of the professional conduct committee or of the health committee, the way in which the Judicial Committee of the Privy Council will deal with appeals is set out in subsection (7). It says, "Without prejudice to the application of that Act, on an appeal under this section to Her Majesty in Council, the Judicial Committee may in their report recommend to Her Majesty in Council—

(a) that the appeal be dismissed;
(b) that the appeal be allowed and the decision questioned by the appeal quashed;
(c) "—
this is the point with which we are concerned—
that such other decision as the Professional Conduct Committee or (as the case may be) Health Committee could have made be substituted for the decision questioned by the appeal; or

(d) that the case be remitted to the Committee concerned to be disposed of in accordance with the directions of the Judicial Committee."
Let us suppose that the Judicial Committee decided to adopt a course under subsection (7)(c) and that it substituted what it considered to be the appropriate response to the allegation against which the appeal was formed. The Judicial Committee of the Privy Council decides what is the appropriate penalty to impose or the appropriate step to take.
Once that stage has been reached under amendment No. 59, clause 22(6) will be affected. If unamended, that subsection will deal only with decisions made in the first instance by the professional conduct committee or the health committee. When those committees reach a conclusion,
At any time while a conditions of practice order is in force under this section, the Committee may (whether or not of its own motion)—

(a) extend, or further extend, the period for which the order has effect;
(b) revoke or vary any of the conditions;
(c) require the osteopath concerned to pass a test of competence specfied by the Committee;
(d) reduce the period for which the order has effect; or
(e) revoke the order."



It is clear that the amendment, if passed, will undermine the purpose of taking appeals to the committee of the Privy Council. If that committee then substitutes an order that, in its view, should have been made by the health committee or the professional conduct committee in the first place, it can override, reverse or otherwise interfere with the original decision.
11.30 am
The amendment cannot possibly have been intended so to undermine the value of the process of appealing to the committee of the Privy Council. I urge my hon. Friend to give careful consideration to the consequences of his proposal and to ensure that it is further amended to avoid those consequences. The matter is complicated and I do not expect an immediate response—which, in any case, would not be possible under the rules of the House. However, I urge my hon. Friend to ensure that the amendment is itself amended—although I appreciate the merit of what it attempts to achieve. Its drafting is clearly deficient.

Mr. Moss: I shall attempt to answer some of the points raised by my hon. Friends the Members for Upminster (Sir N. Bonsor) and for Stamford and Spalding (Mr. Davies).
The issue of compensation has been raised twice. Let me repeat what I said earlier: the Bill provides no grounds for compensation at any stage. However, in all other statutory regulation schemes affecting the health professions there is also no compensation clause. The insertion of such a clause in this Bill would be a first.
My hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland) asked about the General Medical Council. I suggest that my hon. Friend the Member for Stamford and Spalding consult his father, who will tell him that no compensation scheme is paid under the GMC's procedures. I would have expected my hon. Friend the Member for Stamford and Spalding to know that.

Mr. Quentin Davies: rose—

Sir Nicholas Bonsor: Before my hon. Friend leaps to refute my scurrilous allegation of a shortage of knowledge to which I myself am happy to admit, let me explain that the crux of my hon. Friend's point—the part that I was endorsing—related not to a desire for a compensation clause, but to a desire for a mechanism limiting the time that could be taken.

Mr. Moss: I was coming to that. Clause 24(4) states:
Before making an interim suspension order, the Committee shall give the osteopath in question an opportunity to appear before it and tc argue his case against the making of the proposed order.
Under subsection (5),
At any such hearing the osteopath shall be entitled to be legally represented.
There is an appeal procedure, again with legal representation. Under clause 31(3),
The order shall specify the period of the suspension, which shall not exceed two months beginning with the date on which the order is made.

Amendment agreed to.

Amendments made: No. 60, in page 17, line 39, after 'section', insert
'or by virtue of a recommendation under section 30(7)(c)'.

No. 61, in page 18, line 42, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c)'.

No. 62, in page 19, line 2, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c)'.

No. 63, in page 19, line 12, after 'section', insert
'or under section (Appeals against decisions of the Health Committee) or by virtue of a recommendation under section 30(7)(c)'.—[Mr. Moss.]

Clause 26

INVESTIGATION OF ALLEGATIONS: PROCEDURAL RULES

Mr. Moss: I beg to move amendment No. 17, in page 21, line 42, leave out paragraph (e) and insert—
'(e) securing that —

(i) any hearing before the Professional Conduct Committee is held in public unless the Committee decides that it is in the interests of the person making the allegation, or of any person giving evidence or of any patient, to hold the hearing or any part of it in private; and
(ii) any hearing before the Health Committee is held in private unless the Committee considers that it is appropriate to hold the hearing or any part of it in public;'.

Mr. Moss: Amendment No. 17 is concerned with the hearings of the professional conduct and health committees. As currently drafted, the Bill provides for either committee to hold its hearings in public unless it considers it appropriate for a particular hearing to be held in private. In deciding whether to hold a hearing in private, the committees will be able to take into consideration the interests of the person making the allegation, or of any patient or other person giving evidence—or, in the case of the health committee, the interests of the osteopath concerned.
The amendment has two purposes. First, it builds in a degree of flexibility to enable either committee to hold part of the hearing—as distinct from all of it—in public or in private. Secondly, it changes the default position of the health committee's hearings by providing for them to be held in private unless the committee considers it appropriate to hold all or part of them in public.
The second feature is the more significant. Health committee hearings are likely to raise matters of a personal and sensitive nature. They could, for example, shine a spotlight on a medical problem which, until then, the osteopath had refused to recognise. It may also be necessary to discuss, or ask for evidence to be produced about, matters of a very personal nature. That could make the whole procedure rather traumatic.
It is important for the Bill to recognise that proceedings before the health committee would be completely different from those that take place before the professional conduct committee. The professional conduct committee hearings will focus on allegations of misconduct, incompetence and conviction of a criminal offence: they will be concerned with matters of professional discipline. That will not apply to health committee hearings. For the reasons that I mentioned earlier, there will be an imperative need for confidentiality; without that, the procedures would risk failing to win the confidence of the profession. It could also mean that any encouragement that the GOC may try to give the profession in the future to refer cases of sick colleagues would be met by a wall of silence. Changing the default position of the health committees' hearings in this way would overcome those concerns, and would also bring


the osteopaths scheme into line with the practice adopted by other statutory schemes for health professionals which make provision for a similar committee.

Mr. Quentin Davies: I have some problems with the amendment. The assumption behind it is that, whereas it may be a matter of public interest for a case to be heard by the professional conduct committee—in the sense that unprofessional or criminal conduct on the part of the practitioner may be alleged—the health of a practitioner is not a matter of public interest.
Is it not a matter of public interest that, for example, a practitioner may have AIDS? I cannot comment on the possibility of HIV being transmitted from practitioner to patient during a course of osteopathic treatment, but I shall be interested to hear what my hon. Friend has to say about that. As my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) knows, the question whether medical practitioners have an infectious disease has become a matter of intense public interest in recent months. That must be especially true in the case of a disease such as HIV, for which there is no cure and in respect of which the prognosis is always fatal.
No doubt my hon. Friend will respond with his usual courtesy and knowledge of the subject. I hope that, in doing so, he will not refer me again to the practice of the medical profession and the BMA general council and disciplinary committee—for several reasons. First, I do not pretend to hold a brief—and nor, I think, would my father wish to say that he held a particular brief—for the BMA.
Secondly, the BMA and the royal college have existed for many generatns. There is therefore an established jurisprudence: we can see how in practice the BMA handles allegations of professional misconduct and so on. That means that concerns such as those expressed today about, for example, the time that investigations will take and about compensation do not necessarily arise with the same force. We have a whole record of historic experience of the BMA, whereas in the Bill, however, we are setting up a completely new and untested body. There will be some comfort to be taken from the fact that the body will be under the supervision of the Privy Council, but we do not know who the members of the council will be. Osteopaths have no record of supervising themselves and their profession. I am sure that they will make a great success of it, but if we are to set the new body on the right course, it is appropriate for such questions to be asked and that they should be convincingly and adequately answered.
Finally, doctors in particular would find it especially ironic were they told that osteopaths would never aspire to higher standards than the medical profession and that, where the medical profession has certain established procedures—for example, for disciplinary hearings—higher standards could not possibly be set in a new Bill to establish a new professional body for a new profession.

Lady Olga Maitland: In considering when evidence should be given in public and when in private, it is extremely important both to prevent a witch hunt and to keep the public interest very much in mind. There must be a careful delineation and a careful judgment about when each is appropriate. I imagine that a patient would find it

well-nigh impossible to give evidence on very personal matters if he knew that the information would be in the public domain. That point of view must be respected if, without such evidence, the investigation could not continue.

Sir Nicholas Bonsor: I am puzzled about the logic and one of the consequences of the amendments. As I understand it, the original hearing will be in private if it is before the health committee, but the appeal will be in public. My hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) said earlier that he thought that there was a difference, in the sense that the original hearing was at the instigation of someone who was making a complaint whereas the appeal was at the instigation of the osteopath against whom the complaint was made. Presumably, we are supposed to think that that justifies the fact that the second hearing will be in public whereas the first has been in private. I do not follow the logic of that.
It is true that it is the osteopath who brings the appeal, but he would not have to bring the appeal if he did not feel aggrieved by the judgment in the first hearing. I do not see why he should be forced, by the application of a different criterion, to bring all these matters out into the open, having been able to keep them within the privacy of the general council in the first instance.
I take the points made by my hon. Friends the Members for Stamford and Spalding (Mr. Davies) and for Sutton and Cheam (Lady Olga Maitland). None the less, I feel that the osteopath should have a right of privacy and, in circumstances in which it is held to be correct that he should be allowed to have a hearing in private in the first instance, there is a lack of justice in the matter being forced into the open on appeal.

Mr. Sackville: We are discussing the important question of fitness to practise. The King's Fund working party described the need to secure a high standard of professional conduct among registered practitioners as
one of the primary functions of the Council of a self-regulating profession.
It went on:
Although detailed arrangements for ensuring this vary slightly from one profession to another, the features common to most professions are: first, the promulgation of ethical notes for the guidance of practitioners or rules of professional conduct; secondly, machinery for investigating allegations of unacceptable professional conduct; and, thirdly, procedures governing the preferment of charges before, and the hearing of charges and the imposition of penalties by, a suitably constituted domestic tribunal.
Readers of the Bill will be aware that those are all important elements of the proposed statutory scheme.
My hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) has already said that not all other similar statutory schemes make provision for a health committee. The King's Fund working party commented that the statutory provision of a health committee has been made in more recent times
for the better protection of both practitioners and the public … to deal with those practitioners who should not be allowed to practise for reasons of ill health.
The King's Fund working party went on to recommend the establishment of a health committee which would be
responsible for hearing cases referred to it by the Investigating Committee where it seems to the latter that there is prima facie evidence of ill health sufficient to warrant suspending a practitioner's right to practise altogether or


requiring him or her as a condition of continuing registration to comply with certain conditions (for example to practise under supervision)".
Once again, my hon. Friend's Bill incorporates a key recommendation of the working party. In addition to ensuring that the fitness-to-practise machinery provides adequate safeguards for members of the public, it is important that it has the ability to take account of the needs of osteopaths in appropriate circumstances. My hon. Friend has described the need to provide for hearings of the health committee to be in private unless the committee considers it appropriate for all or part of a hearing to be in public. I fully support his argument. Such hearings are likely to touch on sensitive and personal matters that neither have a place within, nor a need to be brought into, the public domain.

Mr. Quentin Davies: Will my hon. Friend the Minister concede that if an osteopath has an infectious and extremely dangerous disease that he might have passed on to his patients, it would be a matter of concern, at least to his patients, to know whether they had contracted that particular virus or bacterium? In those circumstances, it would not be right to keep the facts of the case purely to the privacy of the health committee meeting.

Mr. Sackville: My hon. Friend makes a fair point. However, I refer him to the guidelines for the medical profession, that make a clear distinction between procedures that are invasive and likely to give rise to the transmission of HIV or similar infections and procedures that are not. Those guidelines are very clear. I also remind my hon. Friend of recent announcements that put into perspective the whole question of the infectiveness of those who carry the HIV virus.
In addition to ensuring the fitness to practise machinery to provide safeguards, it is important to take the needs into account. I welcome the flexibility that the amendment provides in balancing the wider public interest with that of an individual witness appearing before the professional conduct committee. Without the amendment, the committee would have the choice only between holding the entire hearing in public or in private. If the amendment is accepted, it will enable the committee to take that decision in respect of different parts of the hearing.
Therefore, the amendment is important to fine tune the provisions of the fitness to practise machinery. I join my hon. Friend the Member for Cambridgeshire, North-East in urging the House to accept it.

Mr. Moss: The question raised by my hon. Friend the Member for Stamford and Spalding (Mr. Davies) about HIV status has been clarified by my hon. Friend the Minister.

Mr. Quentin Davies: The Minister said that the guidelines laid down for the medical profession which distinguish between diseases that hold some hazard for patients and those that do not are very clear. He is right: they are clear. My point is that they are not clear in respect of the osteopathy profession for which we are now legislating. Should not the clarity that exists in the medical profession be introduced into the osteopathic profession by virtue of the Bill?

Mr. Moss: My hon. Friend the Minister made it quite clear that the rules and guidelines issued by the

Department of Health are clear cut. As osteopaths do not use invasive procedures, they do not come within the ambit of the Department's guidelines.

Mr. Sackville: My hon. Friend the Member for Stamford and Spalding (Mr. Davies) was mistaken when he referred to diseases. He should have referred to the procedures. That is the differentiation which must be made.

Mr. Moss: My hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland) made an excellent point. She was absolutely right, and her point goes to the heart of the amendment. We want to establish a situation in which the choice exists with relation to investigations before the health committee. We are not saying that the hearing must be in private or in public. We are saying that it can be held in private unless the committee considers it appropriate to hold the hearing, or any part of it, in public. The choice is there.
My hon. Friend the Member for Upminster (Sir N. Bonsor) drew attention not to a discrepancy, but to a difference in relation to the wording of new clause 3 about appeals that are held in public and the opportunity for hearings to be heard in private in respect of the health committee investigation. The appeal in public in respect of the health committee is subject to rules covered in the Bill. Those rules could say that the appeal should be in private if the osteopath so requests.

Amendment agreed to.

Clause 29

APPEALS AGAINST DECISIONS OF THE REGISTRAR

Sir Nicholas Bonsor: I beg to move amendment No. 52, in page 23, line 40 leave out 'on a point of law'.
The amendment deals with the question of an appeal to an appropriate court in the event of a registrar refusing to register an applicant or to take some of the other steps open to him that might leave the applicant aggrieved. If that happens, the applicant should appeal to the general council.
Under clause 29, an appeal to the general council will be
subject to such rules as the General Council may make for the purpose of regulating appeals under this section.
That relates to the point very fully and ably made by my hon. Friend the Member for Stamford and Spalding (Mr. Davies) about the way in which we are taking the Bill forward.
It is far from clear—and we have no guidance about this—what rules the general council may make in those circumstances. In respect of the clauses that deal with what the general council can do with regard to the health committee and the committee that deals with complaints of a criminal or disciplinary nature, there is a long list of things about which the council may or shall make rules. I have already expressed at length my reservations about the flexibility which is allowed to it even in those circumstances, but in these circumstances there are absolutely no rules limiting what the general council can do. Under subsection (2), it is clear that it may make such rules as it wishes.
I take into account the fact that the general council will be a very worthy body, and that it will have not the slightest desire to make any rules that are not in the interests of justice or the interests of those who are to be


subject to these procedures. None the less, the members will not be legally qualified. It must be a matter of concern that, in something that is starting from an entirely clean sheet and in respect of which there are no precedents, there is no measure by which we can judge the way in which the council is likely to proceed. We must have substantial concern about whether justice will be done in such circumstances.
It is the core of the Bill that there should be a properly compiled register, that the terms of registration should be subject to rules and that the ways in which registration is dealt with are properly administered. It is no good at all arriving at that stage and finding that, when an appeal is made because something has gone wrong, those rules go out the window and other rules are substituted that might fall very far short of the standard that we would require.

Mr. Quentin Davies: Is not the substance of the clause unamended and the problem, therefore, that my hon. Friend is addressing in his amendment the fact that the existing text of the Bill is, in effect, an attempt to prejudice the decision of a court—or rather, to use statute in an effort to prevent a court from subsequently accepting jurisdiction as it might choose otherwise to do on any appeal or on any event arising from an alleged breach of justice during the procedures that have been laid down in the Bill—that is, the disciplinary procedures and the appeals on them? Is it not thoroughly unsatisfactory that we should legislate in this way, by explicit legislation of this kind, to try to prevent a court from subsequently accepting jurisdiction and examining the full facts of the case, as that court might decide it is appropriate to do in the circumstances at the time?

Sir Nicholas Bonsor: My hon. Friend has a very good habit of anticipating everything that I wish to put before the House. Of course he is right. I am now coming to the point of my amendment, which is specific, relating to clause 29(4), which, as unamended, states:
Any person aggrieved by the decision of the General Council on an appeal under this section may appeal, on a point of law, to the appropriate court"—
that is, appeal on a point of law only to an appropriate court.
If the general council and the registrar were in error of fact, the court—whichever court would be the appropriate one; almost certainly it would be the High Court of Justice —would be debarred from hearing a case in which the grounds of the appellant's reasoning to try to go to that court were based on art error of fact.
We do not know what rules the general council will make with regard to appeals against the decision of the registrar, but it would not be acting in any way out of precedents from other organisations were it to adopt a procedure that is limited to taking evidence in writing, for example. There are many instances in quasi-judicial bodies in which evidence in writing is all that is considered by the regulatory body, and no opportunity is given to the person who is aggrieved to give evidence in person, to call witnesses to answer questions, or to cross-question those who oppose a decision.

Mr. Bowis: Will my hon. Friend explain whether the aggrieved person could be the registrar, on the assumption that the previously aggrieved person has won one stage of

the appeal and therefore the registrar could be the aggrieved person at the next stage? I do not understand the relationship between subsection (4) and the next one, which appears to suggest that subsection (4) is in addition to any right of appeal elsewhere. Does that cover my hon. Friend's point? If so, there appears to be legal complexity and confusion that need to be clarified.

Sir Nicholas Bonsor: In response to the first of the two questions that my hon. Friend put, clearly the registrar could not be the aggrieved person, because subsection (4) deals only with matters arising out of subsection (1). The contents of subsection (1) relate entirely to what the registrar has decided to do. The chances of the registrar appealing vigorously against his own decision seem unlikely—indeed, impossible. The answer to my hon. Friend's first question is that the appeal will take place only when the registrar has done something which, in the view of the person whom he has damaged, he should not have done.
12 noon
In response to my hon. Friend's second question, I am not absolutely clear, to be honest, why subsection (5) has been put in. If there is a small claim that could go to a county court instead of the High Court, subsection (5) seems to exclude the limitations of subsection (4), so that, in the event of a small claim, it would appear that, on a matter of fact, the appellant could still take the case to court.
However, if an osteopath is not registered by the registrar, and if that is wrongful, the level of damage that the osteopath will suffer will be way beyond anything that it is within the competence of the county court to amend or give adequate damages for. So the significance of subsection (4) is that in a matter that could have serious financial consequences, the person involved will be debarred from taking any case to court unless he can find a point of law on which he can base his claim for redress. I fear that it will often not be possible to do so, because most of the decisions do not turn on points of law such as whether the tribunal acted outside its powers or whether something was done that the laws of the land say should not have been done.
It is much more likely that the registrar will base his decision on a fact that the aggrieved person alleges to be false. I can think of few circumstances in which subsection (4) would allow an appeal against the decision. Therefore, I am extremely concerned that the amendment should be accepted and that "on a point of law" should be deleted from the clause.
Earlier today, my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) said that appeals to the Judicial Committee of the Privy Council should be only on a point of law, because the committee did not want to have to find on detailed matters of medical fact. From several years of experience of practice in English law, I can assure my hon. Friend that the High Court has no such inhibition. If it did, many people who have been injured by the medical profession would find it difficult if not impossible to achieve redress, because they would not find a judge who was willing to set himself up to try such a case. That is not how English law operates.
In English law, the judge sits in court and takes evidence from experts in the medical field and comes to a proper conclusion. If he does not, one can go to the Court


of Appeal. So, whatever may or may not be the case for an appeal to the Judicial Committee of the Privy Council, the reason that my hon. Friend gave cannot justify removing the right of an aggrieved person to take an appeal from the general council to the High Court. I hope that my hon. Friend will take that point.

Mr. Moss: I rise tentatively to answer my hon.—and learned—Friend after five minutes of learned exposition. As he said, the amendment seeks to provide for the appeal to the High Court, or its equivalent under the clause, to be permitted on any ground and not merely on a point of law. Clause 29 deals with appeals against a decision of the registrar connected with registration. The appeal to the High Court is neither the only answer nor the first appeal provided against a decision that the registrar might make under clause 29.
In the first instance, the osteopath would have a right of appeal to the general council. It would be an open appeal that would not be restricted to points of law and would amount to a complete re-examination of the case in question. In addition to an appeal being permitted from the council on the ground that the council had got the law wrong—

Sir Nicholas Bonsor: Will my hon. Friend give way?

Mr. Moss: If my hon. Friend will forgive me, I am in mid-sentence. I do not mind being subject to a hard time, but being stopped in full flow is a little off-putting.
An appeal could be permitted if it were felt that the general council had got the law wrong. In addition, a decision of the general council that was so unreasonable as to be perverse would also be eligible for appeal to the High Court, because that would involve a point of law.

Sir Nicholas Bonsor: I apologise to my hon. Friend, but I tried to interrupt him before he had completed that sentence because he had moved off the point on which I wanted to intervene about a full re-examination of an appellant's case by the general council.
That relates to my concern about there being no guarantee under clause 29(2) about how the general council will make the rules about an appeal. There are plenty of precedents in other circumstances where such an appeal did not amount to a full rehearing of a case. My hon. Friend is not in a position to assure the House that that will not be the case under the Bill, because it is subject to a decision that the general council has not yet been called upon to make. My concern is that we are putting on the statute book a Bill which cannot guarantee an aggrieved person the rights that my hon. Friend has told us that that person will have.

Mr. Moss: I hear what my hon. Friend says, but he has omitted to say that all the rules that the general council will introduce, in good time, will be looked at most carefully by the Privy Council. If it feels that the general council is not moving in the right direction, it can intervene in the interests of natural justice.
Although I concur with the intention behind my hon. Friend's amendment, it is unnecessary for the appeal to the High Court or its equivalent to amount to a secondary consideration of the matter. I urge the House to reject the amendment.

Sir Nicholas Bonsor: I remain profoundly disturbed by this part of the Bill and I fear that injustice may result from

it. In the light of what my hon. Friend has said, however, and the assurances that he has given, I, with some reluctance, beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 30

APPEALS AGAINST DECISIONS OF THE PROFESSIONAL CONDUCT COMMITTEE AND THE HEALTH COMMITTEE

Amendments made: No. 18, in page 24, line 12, leave out 'of the Health Committee is made under section 23', and insert 'is made by an appeal tribunal hearing an appeal under section (Appeals against decisions of the Health Committee)'.

No. 19, in page 24, line 21, at end insert—
'() An appeal under subsection (1)(b) may only be on a point of law.'.

No. 20, in page 24, line 24, leave out 'may appear as' and insert 'shall be the'.

No. 21, in page 24, line 39, after 'Committee' insert 'or appeal tribunal'.

No. 22, in page 24, line 42, leave out subsection (8). —[Mr. Moss.]

Clause 31

OFFENCES

Amendments made: No. 23, in page 25, line 7, leave out
from 'by' to 'rules', in line 8, and inseret—

(a) the Professional Conduct Committee,
(b) the Health Committee, or
(c) an appeal tribunal hearing an appeal under section (Appeals against decisions of the Health Committee), under'.

No. 24, in page 25, line 8, after '(h)' insert
'or under any corresponding rules made by virtue of section (Appeals against decisions of the Health Committee) (4)'.— [Mr. Moss.]

Clause 32

COMPETITION AND ANTI-COMPETITIVE PRACTICES

Mr. Moss: I beg to move amendment No. 25, in page 25, line 31, at end insert—
'() For the purposes of any order under section 56 of the Act of 1973 or section 10 of the Act of 1980, section 90(4) of the Act (power to apply orders to existing agreements) shall have effect in relation to a regulatory provision as it has effect in relation to an agreement.'.
At present non-statutory professional associations of osteopaths are subject to the monopoly provisions of the Fair Trading Act 1973 and the provisions concerning anti-competitive practices in the Competition Act 1980.
The Secretary of State for Trade and Industry has the authority to make orders by statutory instrument to require the associations to make any changes to their rules or guidance, that the Secretary of State considers necessary, to remedy effects that a Monopolies and Mergers Commission report have found to be adverse to the public interest.
The purpose of clause 32 is to ensure that the statutory regulations of the osteopathic profession should not remove the rules of the profession from the scope of competition law. That would be the result if rules made under statutory authority were not considered to be agreements for the purposes of the Fair Trading Act 1973.
Clause 32 empowers the Secretary of State to make a competition order under the provisions of the Fair Trading Act or the Competition Act in respect of any


regulatory provisions made by the general council and its statutory committees—the education committee, the investigating committee, the professional conduct committee and health committee—or any of its other committees, including sub-committees.
The amendment makes it clear that the principle is that regulatory provisions, as defined under clause 32(1) shall be treated as agreements—the purpose of orders made by the Secretary of State follow reports by the Monopolies and Mergers Commission under the Fair Trading Act 1973 or the Competition Act 1980. The amendment makes it clear that the principle applies to section 90(4) of the Fair Trading Act.

Amendment agreed to.

Clause 33

DEFAULT POWERS OF THE PRIVY COUNCIL

Amendments made: No. 26, in page 25, line 36, leave out 'consider' and insert 'considers'.

No. 27, in page 25, line 39, leave out "themselves' and insert 'itself' —[Mr. Moss.]

Clause 35

EXERCISE OF POWERS OF PRIVY COUNCIL

Amendment made: No. 28, in page 26, line 20, leave out 'or 17' and insert

'17 or (Appeals against decisions of the Health Committee)'. —[Mr. Moss.]

Clause 36

PROFESSIONAL INDEMNITY INSURANCE

Sir Nicholas Bonsor: I beg to move amendment No. 54, in page 26, line 33, leave out 'may' and insert 'shall'.
I return to my favourite hobby horse—the difference between "may" and "shall" under clause 36, which is designed to ensure that practising osteopaths are properly insured should anything horrible happen to their patients. I declare an interest in that I am a member of Lloyd's and could be said to have an minor vested interest in whether people insure themselves. My hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) has a more direct interest, as a broker, in seeing that people are properly insured.
Putting aside all such personal interests, I believe that there can be no doubt that it is in the interests of patients for osteopaths to be adequately insured so that, in the awful event of their being negligent and something happening to their clients, they can obtain a remedy in the courts for their injuries. We should not have the appalling incidents, that sometimes occur, where patients successfully sue, but then find that the person sued is a man of straw. In those cases, such patients cannot obtain redress.
Therefore, I am profoundly unhappy that, under clause 36, the general council is left with the discretion to decide whether to ensure that its osteopath members are insured. While osteopathy is a science, not an art, it is an imprecise science. There is no doubt that there are instances where the treatment does not work and those being treated come

out worse than when they went in. That is true of most professions and I am not singling out osteopathy, which can be beneficial but can also be harmful.
As a result of my indiscretions as a youth when I drove a fast car, I am a frequent client of osteopaths and, over the years, I have found them to be a mixed bunch. Some of them have done me much good. However, one osteopath who treated me 10 or 12 years ago in Cheshire, who was much used by the Cheshire hunt and had a superb reputation, left me in a state of almost total immobility. I spent half an hour on his couch and came away in excrutiating agony. I returned to London and, following a visit to my usual osteopath, emerged more or less in one piece.
There is no doubt that there are likely to be cases in which osteopaths are sued for what they have done and it is extremely important that they should have the resources behind them so that the person whom they have injured can obtain financial compensation. It is unsatisfactory for the general council to be left with discretion in that matter. I hope that the House and my hon. Friend the Member for Cambridgeshire, North-East will accept the amendment.

Mr. Bowis: I entirely endorse the issues raised by my hon. Friend the Member for Upminster (Sir N. Bonsor). It seems osteopathy is now becoming a profession which should require professional indemnity insurance. My hon. Friend mentioned the rules governing insurance brokers, and such insurance is required for them. It is common among professions for indemnity to be a requirement and I see no reason why it should be an option for osteopaths. If the Government have any doubts, I should point out that in previous cases where insurance policies have been lacking, it is inevitably the Government who are asked by the public to compensate someone for something that has gone wrong. It is in the interests of the Government, the profession and the patients that the Bill should read "shall", not "may".

Mr. Sackville: I must remind my hon. Friends the Members for Upminster (Sir N. Bonsor) and for Battersea (Mr. Bowis) that the Bill is about self-regulation, not about laying down in detail every aspect of how the profession should be run. The Bill builds on almost half a century of successful self-regulation by the profession, so it would be out of place if we began now to lay specific duties on the profession in respect of insurance. I should like the House to consider the amendment in that light and I ask my hon. Friend not to press it.

Mr. Moss: With this amendment my hon. Friend the Member for Upminster raises one of the most important aspects of the legislation. I appreciate the sensitivities that surround the important subject of professional indemnity insurance. I know that the profession takes the matter seriously and I am sure that the general council will consider it with equal seriousness. The profession clearly demonstrated through its voluntary registration scheme that it has a responsible attitude towards patient safety.
The need for practitioners to hold professional indemnity insurance was also a key recommendation of the King's Fund working party report. I am confident, however, that the recommendation did not emanate from a concern that the professionals' attitude was in any way lacking in this area. The amendment brings us back to the


debate on whether the general council should be required to make rules or should be allowed to make up its own mind.
I have already made clear my reasons for believing that it would be a mistake to remove from the general council the responsibility for making this decision. Agreeing to the amendment would be to tell the council that we do not trust it to make a sensible decision—a terrible indictment of both council and profession. It would also cut across the principle of self-regulation on which the scheme is to be founded.
I remind the House that the provisions of clause 36 are perhaps the most comprehensive in any health care statutory scheme. They would enable the general council to make rules to require practising osteopaths to hold professional indemnity insurance. The general council would also have the power to check that a practitioner had renewed his cover at the right time and, most important, to initiate disciplinary proceedings if he had not.
My hon. Friend the Member for Upminster referred to a connection with the insurance industry which he and I might have. I remind him that the industry itself is wholly against any mandatory requirement in the legislation requiring insurance of any kind, because that runs counter to selectivity.
I have received a letter from the deputy chief executive of the Association of British Insurers. I received it during the Committee stage, but it is relevant to my hon. Friend's
point:
I thought that it would be of assistance to you to be aware that the ABI is pleased to see that regulation now leaves the question of professional indemnity insurance to the discretion of the general osteopathic council. This satisfactorily avoids the insurance industry being placed in the position where a refusal to provide professional indemnity to an osteopath might lead to an accusation that he was being deprived of his livelihood by non-availability of insurance. Insurers must retain the right to decline to provide insurance in individual cases and to charge a premium at a level they regard as appropriate but which an osteopath might regard as excessive in his particular case.

Mr. Bowis: I hope that we are not seeking to establish the principle that there should never be a requirement for insurance. The cost of insurance may reflect the status and standing of a person or business seeking the cover. That should not be a reason for not requiring insurance but for making sure that those seeking cover reach the required standards. In many instances, legislation requires insurance by employers and public liability companies or professions. I accept what the Minister said about self-regulation. That may be a strong steer from the House that we expect rather than require the taking out of insurance.

Sir Nicholas Bonsor: As my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) has not risen, I assume that he does not wish to reply to the last point by my hon. Friend the Member for Battersea (Mr. Bowis). I take issue with the Minister who seemed to imply that, because the Bill is self-regulatory, the House should not lay down any principle by which the excellent people who will make up the general council should abide. The Bill is littered with requirements. Clause 6 states what the register shall show and clause 19 states:
The General Council shall prepare and from time to time publish a Code of Practice
It also states what the code of practice shall be. Clause 20(12) states:

Where the Investigating Committee concludes that there is a case to answer".
Throughout the Bill, Parliament in its wisdom has decided what the general council shall do, and rightly so. Although there is to be self-regulation, there is a clear need for central guidance so that the public and the House can have confidence in that self-regulation.
I take note of what my hon. Friend the Member for Cambridgeshire, North-East said about insurance. I also note the desire of the Association of British Insurers that insurance should not be compulsory. I entirely take that point, but I am concerned that the less insurable the osteopath, if I may put it that way, the greater the risk to his patient. If an osteopath is so uninsurable as to make his practice unviable, his clients should be placed in a strong state of red alert before they lie on his couch.

Mr. Quentin Davies: Did my hon. Friend have the same difficulty as I had in following the logic of the letter from the deputy chief executive of the Association of British Insurers which was read to us by my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss)? The general council, using the discretion that my hon. Friend would like to see in his Bill, may decide that a rule for registration is that every practising osteopath shall carry professional liability insurance. If that rule emanates from the general council rather than from statute, it will be open to an osteopath who has been refused insurance to claim that the insurance industry is depriving him of his livelihood. The effect on the registered osteopath who has been denied insurance will be the same whether the rule that he has to carry insurance is imposed by the general council or by statute. The difference that the amendment would make to the text of the Bill should make us consider whether we would feel confident that, in all circumstances, osteopaths will carry insurance or whether we have to take it on trust that the general council will use its best judgment in deciding whether to impose such a rule. That is a different issue from the one that was addressed in the letter from the ABI.

Sir Nicholas Bonsor: My hon. Friend is right. The logic of the letter from the ABI is that the osteopath should have insurance, but it should not be compulsory. The true state of affairs is that it is more than likely that the osteopath will not have any insurance at all, but that the client will not know that. That is the focus of my concern. I fear that we shall end up with people practising on the margin of their profession, probably with very few personal assets, and that their clients will be at substantial risk.
In the light of what has been said, my amendment would not be appropriate. I ask my hon. Friend the Member for Cambridgeshire, North-East to see whether there is a way to safeguard the client's position in the event of an osteopath practising neither with substantial personal wealth nor with an insurance policy that will cover his client against the consequences of any negligence on his part or any legal liability arising. I hope that the Bill will not proceed through the other place without an appropriate amendment being inserted. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 39

INTERPRETATION

Amendment made: No. 29, in page 28, line 20, leave out 'as his address'.—[Mr. Moss.]

Clause 40

SHORT TITLE, COMMENCEMENT, TRANSITIONAL PROVISIONS AND EXTENT

Mr. Moss: I beg to move amendment No. 30, in page 29, line 1, leave out subsection (6) and insert—
'(6) The transitional provisions of Part III of the Schedule shall have effect.'.

Mr. Deputy Speaker: With this, it will be convenient to take amendment No. 45, in page 35, line 36, at end insert—

'PART III

'TRANSITIONAL PROVISIONS

The initial membership of the General Council

43. When first constituted, the membership of the General Council shall be determined in accordance with the provisions of this Schedule as modified by this Part.

The transitional periods

44. In this Part—
the three year transitional period" means the period beginning with the passing of this Act and ending with the third anniversary of the opening of the register;
the four year transitional period" means the period beginning with the passing of this Act and ending with the fourth anniversary of the opening of the register; and
the five year transitional period" means the period beginning with the passing of this Act and ending with the fifth anniversary of the opening of the register.

The osteopathic members

45.—(1) During the three year transitional period, paragraph 1(a) shall have effect as if it provided for the appointment of 12 members by the Privy Council.

(2) Each of those members shall be appointed by the Privy Council after consultation with bodies in the United Kingdom appearing to the Privy Council to represent practising osteopaths.

(3) When appointing any such member the Privy Council shall designate him as a person appointed as one of the 12 members provided for by paragraph 1(a) (as modified by this paragraph).

(4) In this paragraph "osteopathic member" means a member designated under this paragraph.

(5) Each of the osteopathic members shall, at the time of his appointment, be a person appearing to the Privy Council to be a practising osteopath.

(6) One of the osteopathic members shall be expressly appointed as a member who is also a registered medical practitioner at the time of his appointment.

(7) Paragraph 6 shall not apply to any of the osteopathic members.

(8) Subject to paragraphs 4 to 7, the term of office of each of the osteopathic members shall end at the end of the three year transitional period.

46.—(1) The members appointed by the Privy Council under paragraph 1(b) during the five year transitional period shall each be designated by the Privy Council as a person appointed under paragraph 1(b).

(2) In this Part "lay member" means a member designated under this paragraph.

(3) Paragraph 11 shall have effect during the five year transitional period as if "registered osteopaths" and "registered osteopath" read, respectively, "persons appearing to the Privy Council to be practising osteopaths" and "a person appearing to the Privy Council to be a practising osteopath".

(4) Subject to paragraphs 4 to 7, the term of office of each of the lay members shall end at the end of the five year transitional period.

The education members

47.—(1) During the four year transitional period paragraph 1(c) shall have effect as if it provided for the appointment of 3 members by the Privy Council.

(2) Each of those members shall be appointed by the Privy Council after consultation with the Secretary of State.

(3) When appointing any such member the Privy Council shall designate him as a person appointed as one of the 3 members provided for by paragraph 1(c) (as modified by this paragraph).

(4) The 3 education members shall be persons appearing to the Privy Council to be qualified to advise the General Council on matters relating to education and training in osteopathy.

(5) In this paragraph "education member" means a member designated under this paragraph.

(6) Paragraph 6 shall not apply to any of the education members.

(7) Subject to paragraphs 4 to 7, the term of office of each of the education members shall end at the end of the four year transitional period.

The Secretary of State's nominee

48. Subject to paragraphs 4 to 7, the term of office of any person appointed by the Secretary of State under paragraph 1(d) during the four year transitional period shall come to an end at the end of that period.

Appointment of first Chairman

49.—(1) The first Chairman of the General Council shall be appointed by the Privy Council from among the lay members to serve as such until the end of the first meeting of the Council to be held after the first election of members under paragraph 1(a).

(2) If a person appointed as Chairman of the Council during the three year transitional period fails to serve his full term of office as Chairman, his successor as Chairman shall be appointed by the Privy Council from among the lay members for the residue of the unexpired term.

(3) Paragraph 14(3) shall have effect in relation to any Chairman appointed by the Privy Council under this paragraph as if for paragraph (c) there were substituted—
(c) his removal by the Privy Council, where the Privy Council agrees to a request for his removal made by a majority of the other members of the General Council;".

(4) Paragraph 14(3)(d) shall not apply in relation to any person serving as the Chairman appointed by the Privy Council under this paragraph.'.

Mr. Moss: The amendments provide transitional arrangements for the establishment of the first general council. These are important provisions, which I know are of particular interest to the osteopathic profession. The statutory scheme must provide the profession, in the form of its general council, with the means to realise its objectives. For that reason, 12 out of the proposed 24 members of the general osteopathic council will be fully registered osteopaths elected by the profession. Eight of the remaining members will be non-osteopaths appointed by the Privy Council. Those members will represent wider



interests and, in particular, the views of patients. That will help to increase the breadth of experience within the general council and ensure that the profession has a firm and balanced basis from which to develop in the future.
The other four members of the general council will have specific responsibilities for education and training and one will be nominated by the Secretary of State with the other three being appointed by the education committee. The balance of different members is mirrored in all other statutory regulatory schemes and the scheme itself, like all its counterparts, will be overseen by the Privy Council.
It is not possible for the arrangements in the schedule to apply for the first general council because, at the outset of the scheme, there will be no registered osteopaths either to be elected or to vote. Nor will there be an education committee to appoint the three members of the general council concerned with education and training. Special transitional arrangements must be provided to cover the early years. Those arrangements form the substance of amendment No. 45.
There are a number of keys to understanding how the transitional arrangements will work. The first is that all the initial osteopathic lay and educational members of the general council will be appointed by the Privy Council. That is in keeping with the practice followed in the establishment of other statutory schemes and was endorsed by the working party in its report. To ensure that the general council will reflect a balance of good professional opinion, experience and practice, the initial osteopathic members will be appointed after consultation with those bodies that administer the current scheme of voluntary registration. However, the individuals will not be representative of any particular organisation. Nor will they be beholden to any sector interest. They will, instead, be selected on the basis of their individual ability and merit and, in effect, be ambassadors to the profession as a whole.
The second key is the specific identification and linking of the initial osteopathic members, lay members, education members and the Secretary of State's nominee, mentioned under the third heading of the schedule and described under the general council members in paragraph 1. That is an important key. Without it, the establishment of the statutory committee would be thrown into confusion. For example, because all but one of the initial members of the general council are to be appointed by the Privy Council, to which three members of the general council appointed by the Privy Council is paragraph 25(b) referring?
The third key is that the transitional arrangements are primarily concerned with putting the osteopathic members in place. Once the ball for the appointment of other members of the general council is set rolling, they should be able to look after themselves.
The final key is that the initial education members will be appointed in the first instance as members of the general council and their membership of the education committee then follows as a consequence. That is the same principle as will apply, with the possible exception of any co-opted members, in respect of the other members of the education committee—that is, membership of the education committee will flow from a person's membership of the general council.
The transitional arrangements also provide for the initial term of office held by the osteopath members, the education members and the lay members to be three, four or five years respectively. That gives effect to the working party's recommendation to provide

opportunities for gradual change in the membership of the General Council whilst ensuring continuity of experience and expertise by staggering the terms of office of the three groups.
12.30 pm
All that provides a broad-brush picture of the transitional arrangements. However, there are a couple of finer brush strokes that I wish to mention. The first concerns the definition of lay members. Paragraph 11(1)(b) of the schedule describes them as persons
who are not registered osteopaths.
At the outset of the scheme, however, there will be no registered osteopaths. To clarify who is eligible to be an initial lay member, the transitional arrangements describe it as those persons appearing to the Privy Council as not to be practising osteopaths.
The second brush stroke concerns the education members and the Secretary of State's nominee. The education members are to be persons qualified to advise the general council on matters relating to education and training in osteopathy. The Secretary of State's nominee is to be a person qualified to advise the general council on matters relating to professional education. Those criteria are also intended to apply to their successors and form the subject of amendments Nos. 39 to 41, which we shall discuss later.
The first chairman of the general council will be appointed by the Privy Council from among the lay members and will serve until the first meeting of the council following the first election of the osteopath members, which is three years after the day on which the register is opened. At that meeting, the council must elect a new chairman from among its membership. Again, those arrangements follow the recommendations in the working party's report.
The transitional arrangements will provide the establishment of the first general council in accordance with the recommendations of the King's Fund working party. I commend the amendment to the House.

Amendment agreed to.

Mr. Moss: I beg to move amendment No. 31, in page 29, line 5, leave out subsection (7) and insert—
'(7) This Act extends to the United Kingdom except that—

(a) section 37(2) and section (Data protection and access to personal health information) (I)' extend only to Great Britain;
(b) section (Data protection and access to personal health information) (2)(c) and (e) extends only to Scotland;
(c) section 37(3) extends only to Northern Ireland; and
(d) section (Data protection and access to personal health information) (2)(b) and (d) extends only to England and Wales.'.

This is a technical amendment to the extant provisions of the Bill.

Amendment agreed to.

Schedule

THE GENERAL COUNCIL AND COMMITTEES

Amendment proposed: No. 32, in page 30, line 14, leave out paragraph 4 and insert—

'4.—(1) This paragraph applies where a member fails to complete his full term of office.
(2) In such circumstances as may be prescribed, if the unexpired term is less than the prescribed period the vacancy need not be filled before the end of that term.


(3) If the member's successor is elected or (as the case may be) appointed during the unexpired term, the successor's term of office shall, subject to paragraphs 5 to 7, be for the residue of the unexpired term.
(4) Rules made by the General Council under sub-paragraph (2) shall not prescribe a period of more than twelve months.
(5) In this paragraph "the unexpired term" means the period beginning with the date on which the member ceased to be a member and ending with the date on which his full term of office would have expired.'.—[Mr. Moss.]

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments: No. 33, in page 30, line 28, after 'osteopath' insert
'at the time of his election'.

No. 34, in page 30, leave out line 30.

No. 35, in page 31, line 9, leave out sub-paragraph (2).

No. 36, in page 31, line 13, after 'practitioner' insert
 'at the time of his appointment and shall be'.

No. 37, in page 31, line 14, leave out 'Standing'.

No. 38, in page 31, line 16, after 'osteopaths' insert
'at the time of their appointment'.

No. 39, in page 31, line 25, leave out from 'Committee' to 'training', in line 26 and insert
'to be qualified to advise the General Council on matters relating to education and'.

No. 40, in page 31, line 28, leave out from 'consult' to end of line 29 and insert—

(a) those institutions in the United Kingdom by which or under whose direction any relevant course of study is given; and
(b) such other bodies (if any) as the Education Committee considers appropriate.

(3) In this paragraph "relevant course of study" has the same meaning as in section 12(2).'.

No. 41, in page 31, line 32, leave out
'experienced in the provision of medical education' and insert
'qualified to advise the General Council on matters relating to professional education'.

No. 42, in page 34, line 21, leave out sub-paragraphs (3) and (4) and insert—
'(3) Where the Chairman of the Committee is prevented by sub-paragraph (1) or (2) from taking part in an appointment the appointment shall be made in accordance with rules made by the General Council.'.

No. 43, in page 35, line 22, after 'practitioner' insert
'at the time of his appointment'.

No. 44, in page 35, line 33, leave out from '5' to end of line 36 and insert
'none of whom need be registered medical practitioners but at least 3 of whom shall be members of the General Council.'.

Mr. Quentin Davies: I shall try to be brief and not detain the House for too long. I am slightly concerned about two of these amendments, Nos. 40 and 44. Paragraph 12(2) of the schedule states:
Before making any such appointment, the Committee shall consult those institutions in the United Kingdom which award recognised qualifications.
Amendment No. 40 would leave out from "consult" and insert:
(a) those institutions in the United Kingdom by which or under whose direction any relevant course of study is given;
Both the amendment and the original text refer purely to institutions in the United Kingdom. However, earlier in our debates we recognised that provision had been made for osteopaths qualified elsewhere in the European Community, under Community law, to practise in this country.
It might both benefit the profession and enable it to comply with those aspects of Community law that

establish a basis for persons to practise their professions in different Community countries if practitioners from other Community countries were appointed to the general council or if appointments were made to the education committee of members of bodies concerned with the training of osteopaths in other Community countries, whose graduates may exercise their right to practise in this country. It is slightly dubious that we should attempt, by means of the Bill, for all time to exclude the possibility of making appointments from institutions outside the United Kingdom.
I have difficulty in following the logic of amendment No. 44. It appears to provide that the quorum of the health committee should not include a registered medical practitioner. According to paragraph 38 of the schedule, a registered medical practitioner has to be a member of the health committee. However, amendment No. 44 explicitly provides that a registered medical practitioner does not have to be a member of the quorum. Decisions can, therefore, be taken by the health committee without the presence of a registered medical practitioner.
I presume that the purpose of providing for a registered medical practitioner to sit on the health committee is to ensure that a doctor can contribute to the decision on whether somebody's physical or mental health makes it impossible for that person to exercise the profession of osteopath. What is the point of providing by statute for a registered medical practitioner to be a member of the health committee and also providing that he does not have to be a member of the quorum?
The non-medical members of the committee could therefore form a quorum and reach a decision on the medical fitness of an individual to continue to practise as an osteopath without a registered medical practitioner being present and without, therefore, there being any professional medical input into what is effectively a clinical decision by the health committee.

Mr. Sackville: I am grateful to my hon. Friend for upholding the rights and privileges of the medical profession, but I am sure that the chairman of the medical committee will be able to decide who should attend what meetings, and when.
My hon. Friend's point about Europe sounds dangerously federalist. In general, though, I think that it is time that we sent the Bill to another place.

Amendment agreed to.

Amendments made:

No. 33, in page 30, line 28, after 'osteopath' insert 'at the time of his election'.

No. 34, in page 30, leave out line 30.

No. 35, in page 31, line 9, leave out sub-paragraph (2).

No. 36, in page 31, line 13, after 'practitioner' insert
'at the time of his appointment and shall be'.

No. 37, in page 31, line 14, leave out 'Standing'.

No. 38, in page 31, line 16, after 'osteopaths' insert
'at the time of their appointment'.

No. 39, in page 31, line 25, leave out from 'Committee' to 'training', in line 26 and insert
'to be qualified to advise the General Council on matters relating to education and'.

No. 40, in page 31, line 28, leave out from 'consult' to end of line 29 and insert'—

(a) those institutions in the United Kingdom by which or under whose direction any relevant course of study is given; and
(b) such other bodies (if any) as the Education Committee considers appropriate.

(3) In this paragraph "relevant course of study" has the same meaning as in section 12(2).'.

No. 41, in page 31, line 32, leave out
'experienced in the provision of medical education'
and insert
'qualified to advise the General Council on matters relating to professional education'.

No. 42, in page 34, line 21, leave out sub-paragraphs (3) and (4) and insert—
'(3) Where the Chairman of the Committee is prevented by sub-paragraph (1) or (2) from taking part in an appointment the appointment shall be made in accordance with rules made by the General Council.'.

No. 43, in page 35, line 22, after 'practitioner' insert
'at the time of his appointment'.

No. 44, in page 35, line 33, leave out from '5' to end of line 36 and insert
'none of whom need be registered medical practitioners but at least 3 of whom shall be members of the General Council.'. —[Mr. Moss.]

Order for Third Reading read.

Motion made, and Question proposed, That the Bill be now read the Third time.—[Mr. Moss.]

Mr. Sackville: I congratulate my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on having brought what I believe to be the largest private Member's Bill in Parliament's history—I hesitate to say that, given the long history of this Parliament—to a successful conclusion. The Department of Health, which occasionally responded to requests for help in drafting the Bill, supports it. The Bill also reflects the input of 10 Government Departments. The fact that my hon. Friend looks so healthy at the end of all this is a tribute to his resilience.
This is a robust piece of legislation, which weaves through a large number of provisions and policies. It has been carefully considered by the House and has been amended in fairly fine detail. The Government therefore commend the Bill as a finished product, and we are glad to send it in that form to another place.

Ms Primarolo: I am delighted that we have almost reached the end of our considerations of this excellent Bill, which began its progress through the House with all-party support. Many people outside the House will understand why it takes so long to discuss other pieces of legislation in view of the time that it has taken us to consider a Bill on which initially we apparently all agreed.
I absolutely agree with the Minister. I hope that we have the finished product before us and that it will complete its remaining stages speedily. The Bill builds on the excellent King's Fund report on over 50 years' experience in osteopathy, and it has the support of the British Medical Association and, not least, the support of patients and patient organisations. There are 4 million-plus consultations for back pain every year and the overwhelming majority of those involve osteopaths.
If further recommendation for the Bill is needed, hon. Members should consider the report produced by NAHAT, the National Association of Health Authorities and Trusts. The report clearly demonstrates that patients not only have a desire to use osteopaths and complementary medicines, but are using them, that GPs wish to use those services, that health authorities wish to

commission those services and that the medical profession recognises the importance of the contribution of osteopathy and of complementary medicines.
The NAHAT report recommends that those services should be available within the national health service. Therefore, I hope not only that the Bill will rapidly reach the statute book, but that it will be the first in a series of Bills to regulate complementary medicines and to ensure that patients are protected, that they have access to properly qualified professionals and that our health service is offering the full range of available medical treatments.
I congratulate the hon. Member for Cambridgeshire, North-East (Mr. Moss) on his patience and on his dedication in getting the Bill through. I sincerely hope that the slight delay in progress because of the thoroughness of our consideration this morning has not marred his experience of promoting the Bill, and that he may later even consider a Bill to regulate homoeopathy.

Mr. Michael Jopling: I am glad to have the opportunity to speak on Third Reading because of a situation in my constituency about which I have recently received a number of letters, to which I wish to draw the Minister's attention. It is important to know how the situation in my constituency will be affected by the Bill, because it is causing a good deal of concern.
I, too, congratulate my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on his good fortune in the ballot, on his wisdom in selecting this subject for legislation and on his skill in promoting the Bill. I wish him well and I wish the Bill well. I welcome the Bill, although I have some reservations about osteopaths. I know that there are differing views about them. Some think that they are God's gift and some take the opposite view. My inclination is to take the opposite view. I have been to an osteopath only once, and I wish that I had never done so.
While canvassing during the general election of 1964, in which I was first elected to the House, I unfortunately fell heavily on a pavement and suffered acute pain in my back from that moment on. After I had put up with the pain for about a week, someone told me that I should go to an osteopath, and told me where I could find a good one.
Before my hon. Friend introduced measures requiring codes of practice and procedures to check osteopaths' fitness to practice, the greatest accolade accorded to a London osteopath was, "All the ballet dancers go to him or her"; for those in the north, where I live, it was, "All the jockeys go to him or her." I was directed to an osteopath to whom, apparently, all the jockeys went.
The man looked at my back. He felt it, prodded it and twisted me this way and that. Then he said, "I can feel it; you have upset a bone in your back. You have slipped a disc. As you are in the middle of an election campaign, you must wrap cotton wool tightly around the small of your back to keep the heat in. Come back in a week." When I returned in a week, he took all the cotton wool off my back and said, "That's funny—it has come out in a rash. I suppose that it is the badness coming out." I did not quite know what he meant, but I was in a state of total agony, which late at night was relieved only by copious amounts of Scotch whisky.
After the osteopath had twisted me around a second time in return for a large fee, I put up with the final week of the election campaign. Then came polling day, when, mercifully, I was elected to the House for the first time. The very next day, I happened to see a doctor, and asked him if he would be kind enough to look at my back. He said, "Why—what is wrong with it?" I told him that I had been in agony for the past two and a half weeks after falling on it. "Let me look at it," he said.
I took off my shirt and removed all the wrappings, exposing the nasty rash which was still on my back. The doctor said, "How long have you had shingles?" I had had shingles all the time that I had been going to that ridiculous osteopath. Ever since then, I have had a very warped view of osteopaths.
Let me turn to a serious issue raised by an osteopath with a very good reputation—not the one I visited; I should add that that one did not work in my constituency. This osteopath, Mr. Sutton, wrote to me from Windermere to draw my attention to a worthwhile scheme that has operated there for the past 15 months. Osteopathic treatment on the national health service is being offered at the local health centre.
I gather that the scheme has been tremendously successful and that 90 of the 120 patients treated in the first 12 months experienced an improvement of more than 80 per cent. That is an impressive result. Mr. Sutton's patients are selected by their GPs, the criterion being that they have not the means to see him privately.
It appears—I want the Minister to pay particular attention here—that, after 30 June this year, the service will have to stop. That is causing great concern to doctors, to Mr. Sutton himself and, most important, to the patients, who are particularly disappointed. I have had a letter from an extremely well-known doctor in Windermere, Dr. Oakden, drawing my attention to the scheme. He tells me that everyone thought that it was a most enlightened step when the Cumbria family health services authority made funds available under the health promotion scheme for the establishment of the clinic, which is an innovation in Cumbria and, I suspect, elsewhere.
Dr. Oakden tells me that the clinic has been a great success, is used by all the doctors practising in Windermere and has significantly reduced the number of patients needing referral to hospital services for physiotherapy and/or the opinion of a consultant orthopaedic surgeon. It would appear that the scheme therefore represents good value for money for the national health service, too. Dr. Oakden tells me that it may be possible to continue with the clinics, under the arrangements for transitional payments, until April 1994, but that the family health services authority has already told him that it will be unable to find funds thereafter. Dr. Oakden feels that that would be a very great shame.
Dr. Oakden very much endorses Mr. Sutton's request to me for my assistance, which is why I am raising the matter in the House. I want the Minister to give me some indication of how he may be able to help this novel service in the light of a Bill that endorses the competence and public stature of osteopathy—which, as I said, I warmly welcome—

Mr. Sackville: My right hon. Friend is telling us about the provision of osteopathy in a particular area. I shall look into the matter, but it has precious little to do with the Bill, which is about the regulation and recognition of the profession. There is a certain cross-over, but, in essence, my right hon. Friend is talking about choices made by local health authorities or family health services, authorities about the provision of osteopathy in a particular area.

Mr. Jopling: I understand that, and I am grateful for the Minister's comment. When the Bill reaches the statute book—as we all hope it will—it will mean a greater recognition of the competence of osteopaths and, as a direct consequence, there will be much more demand for such services within the national health service. I am glad to see the Minister nodding.
I have had a response from the Cumbria family health services authority, with which I had taken up the issue. The authority tells me that, when the Government introduced the general practitioner contract in 1990, part of that contract allowed for the development of health promotion activity in general practice. Included under the umbrella of health promotion activity was a degree of flexibility, allowing general practitioners and the family health services authorities to develop services which, in the widest sense, could be classed as health promotion, as well as more usually accepted activities such as screening and the prevention of heart disease.
In 1991, the family health services authority was approached by the Windermere practitioners who proposed the plan. Everyone, including the FHSA, understands how effective it can be. The FHSA has pointed out that the Department of Health, in consultation with the professions, has decided that health promotion in general practice should be refocused to emphasise the aspirations set out in the White Paper "The Health of the Nation".
In agreement with the British Medical Association and other representative bodies, the Department has proposed a new system of remuneration for health promotion activity which aims to remunerate practices for providing programmes designed to lower the incidence of heart disease and strokes in the community.
If, as a consequence of the Bill, we find a much greater demand for the services of osteopaths, it is important that the Department of Health and the FHSAs recognise that many worthwhile projects, including the project in Windermere to which I have referred, should develop in the future.
To that end, I hope that my hon. Friend the Minister will consider the situation that I have explained to him. I will send him the correspondence, as I heard only a few days ago from the FHSA. I am most grateful to my hon. Friend the Minister for offering to look into the matter, because this is an exciting new way in which the services of osteopaths can be made available. I commend the experience in my constituency to the House and to the Minister. I hope that those services will not have to be closed down as a result of Government policy, as it affects the way in which FHSAs carry out their business.
On that note, I am delighted to endorse the Bill and to wish it well.

Lady Olga Maitland: I warmly congratulate my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) on steering the Bill through to the statute book. His tremendous effort will be justified by the results.
I want also to congratulate the King's Fund on its report on osteopathy, which helped to set the Bill on the road. The inquiry was chaired so ably by Sir Thomas Bingham and was given a tremendous kick start by the Prince of Wales, who has never made a secret of his temendous faith and belief in the efficacy of osteopathy. Indeed, he sought osteopathic treatment for his broken arm.
The Prince of Wales is well aware of the effect of crippling pain. In 1979, crippling pain led to the loss of 11·5 million working days. More recent figures show that 230,000 people are off work every working day of the year as a result of back pain.
It has always been a tragedy in the past that patients would hobble in agony to the doctor, then waste valuable time before it occurred to them to go to an osteopath. Three sessions with an osteopath could have cured misery which more conventional medicines were unable to help or relieve.
The Bill is long overdue. There have been six attempts since 1931 to introduce legislation on the matter. The last attempt was in December 1991, when Lord Walton of Detchant introduced a Bill in the other place. It was significant that he was so effective, because he is a past president of the General Medical Council. The General Medical Council's support for the osteopathy profession is a sign of the enormous step that it has taken towards general acceptance. Therefore, the Bill marks a coming of age.
There has been debate about the use of the terms "complementary medicine" and "alternative medicine". Now it is clear that osteopathy is truly complementary to conventional medicine. No longer will it be regarded as a fringe source of help. It will truly be part of the mainstream of the medical world. It is significant that more and more GPs refer patients to osteopaths. That is certainly a tremendous improvement on what happened in the past, when a GP would stand almost in pain of professional death if he dared to recommend a patient to another medical profession.
I sought advice from osteopaths in my constituency. They are enthusiastic about the Bill. My right hon. Friend the Member for Westmorland and Lonsdale (Mr. Jopling) referred to an osteopath in his constituency.

Mr. Jopling: He was a disaster.

Lady Olga Maitland: There was another osteopath in my right hon. Friend's constituency. I am not talking about the one who was a disaster.
I spoke to Mr. Midgley in my constituency. He made some relevant points about the Bill, and said that at long last there will be real regulation and standards. He felt very keenly that rogue professionals could attempt some very delicate work and either misdiagnose or create general harm
Osteopathy is the mechanical treatment of the body. It concentrates on the manipulation of sensitive joints and tendons. Enormous damage can be done if a practitioner

is poorly trained or, indeed, untrained. Severe manipulation can result in spinal fractures or even paralysis. That applies in particular to people who suffer from osteoporosis or thinning of the bones.
Similarly, it was pointed out to me that someone suffering from secondary cancers, for example, would suffer if the osteopath were unable to read X-rays. By reading X-rays, an osteopath is able to pick up abnormalities and make recommendations to other forms of medicine. It is terrifying that some osteopaths have abused their patients' trust. Thanks to the enormous work that has gone into the Bill, there will be rigorous standards and a proper register, which will eliminate the dark horses.
It is very interesting that not only have general practitioners accepted the importance of osteopaths but budget-holding GPs have made advances in using osteopathic services. Non-budget-holding GPs may employ the services of an osteopath, particularly if the family health services authority agrees. It is very much a matter of professional judgment.
There are now more than 2,000 practitioners of osteopathy, and the number is increasing. The number advertising their services in my area in Sutton, which covers the whole of south-west London, runs to nearly three pages in the "Yellow Pages". It is estimated that more than 100,000 people seek osteopathic advice each week. The success rate is worth taking into account. In 1989, a MORI poll revealed that 83 per cent. of users were satisfied with their treatment. As the number of osteopaths and their patients increases, the need for consumers to be protected by statutory regulation will increase, as will the satisfaction rate.
The Bill is welcome, because at present any person can set himself up with just a notice on the door. Now the suitability of osteopaths will be carefully examined, and they will have to undergo rigorous training, as we discussed in considerable detail earlier. That is important. The law of negligence insists that osteopaths should be fit and competent and it places on them a duty of care. In the absence of an accepted level of training, it is not clear what the accepted standards are. It is important that we get the standards absolutely right.
There are nine voluntary bodies that osteopaths can join. The principal organisation is the general council and the register of osteopaths, which has about 1,400 members. However, as the Bingham report said, those bodies have no effective sanctions to enforce minimum standards of education, training or competence. That is why I commend the Bill on putting all those matters right.
The Bill also breaks new ground in professional registration by taking powers to suspend osteopaths immediately when the public are thought to be at risk. It also provides the power to impose conditions so that the right people can re-enter the profession after a period of suspension, provided that they have reached the appropriate standards.
Mention was made of the relief given to back pain sufferers and many other patients by osteopaths. I wish to make one special plea. We have broken important new ground. The time has come to give the profession support in providing research facilities. Research into osteopathy has largely been ignored over the years, simply because the practitioners never had the resources to undertake serious research. Research was always done by rule of thumb. I feel that medical research and resources for it will be forthcoming now that the osteopathic profession is fully


recognised and part of the main stream. If the profession is to develop with the energy, enterprise and innovation that it has shown so far, it needs that extra back-up.
I believe that the Bill will set osteopaths new horizons and a new future. I join all hon. Members in commending the path of the Bill so far. I wish it good luck in another place.

Mr. Quentin Davies: My hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) has received some glowing compliments during the debate from hon. Members, including the Minister and the hon. Member for Bristol, South (Ms Primarolo), who speaks for the Opposition. He thoroughly deserves all of them. The hon. Member for Bristol, South expressed the fear that the questioning to which my hon. Friend was subjected this morning might have, to use her phrase, "marred the experience" for him. I thought, rather the reverse.
The great ability with which my hon. Friend dealt with all the questions this morning will have even further enhanced his standing and reputation as a great expert in this field. He showed great dexterity in handling the House. The Bill will be a considerable personal achievement for him and one for which he will be remembered by the profession and its patients for a long time.
In the proceedings on Report I expressed a few pesonal reservations about detailed aspects of the Bill. However, I welcome the Bill. It addresses the essential problem of the lack of credibility which osteopaths have suffered in the past. It has been impossible for the public to distinguish between competent and incompetent osteopaths. There have been too many stories of the type which my right hon. Friend the Member for Westmorland and Lonsdale (Mr. Jopling) told us earlier.
I have no doubt that a clearly defined register of osteopaths and clearly established standards on their qualification, training and education will greatly enhance the credibility of that profession. Those changes will also make it much easier for medical practitioners to refer their patients to osteopaths because they will know that those osteopaths are registered and qualified. There will be no ambiguity about that. That may even make it easier for fund-holding practices to contract with osteopaths under the Government's new rules. It has already been suggested that that may become an ever more frequent practice in the future. Those changes will, above all, greatly increase the confidence of patients when they put themselves in the hands of osteopaths.
A Bill that serves, at the same time, the interests of patients, practitioners of osteopathy and the good health of the nation represents a useful day's work. I add my tributes to those paid to my hon. Friend the Member for Cambridgeshire, North-East for having made that possible.

Sir Nicholas Bonsor: I do not intend to delay the House, but I could not resist the temptation to add my voice to those who have expressed their admiration for the work

done by my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss), who specifically asked me not to do so. The temptation, therefore, became irresistible.
The Bill is a superb example of how a private Member's Bill should be run. As my hon. Friend the Minister has said, it is a complicated Bill and one which does not come directly within the knowledge of my hon. Friend.

Mr. Moss: It does now.

Sir Nicholas Bonsor: After Committee and Report, my hon. Friend has certainly mastered this complex issue. The Bill will greatly enhance the standing of the osteopathy profession and that of my hon. Friend.
In Committee and on Report, we have considered the clauses in great detail. I do not need to go over the ground that we have covered, but I have one word of caution in my general welcome to the Bill. We have given the general council an enormous amount of discretion, more discretion than I should like, as was apparent from my earlier remarks.
I hope that the confidence that the House has expressed about the ability of those who will serve on the general council to fulfil the onerous duties that are being put on them, will be fully justified. I wish them well, and I hope that the profession of osteopathy will thrive. I have personal experience of osteopaths and I know that, for several more years at least, I shall have dire need of one. I hope that the profession will benefit from what we have done today.

Mr. Moss: I am most grateful for the kind comments of my hon. Friends and those of the hon. Member for Bristol, South (Ms Primarolo), who served on the Committee. I thank the hon. Lady and our absent friends from the Liberal Democrats who gave the Bill all-party support at all stages.
I do not wish to detain the House, because I know that other hon. Members are itching to deliberate on the Hedgerows Bill. I feel that I have been dragged through several, such has been the detailed examination of the Bill that I have had to endure this morning. It has, however, been to good effect.
I extend my thanks to the King's Fund working party for providing the framework for the Bill. It is a tribute to its dedication and firmness. I also extend my thanks to the osteopathic profession for its encouragement. I should also like to thank my right hon. Friend the Leader of the House, who, in his previous capacity as Secretary of State for Health, was instrumental in making it possible for the profession to take matters forward.
I congratulate those who served on the Committee, and I thank them for their efforts. I pay tribute to Simon Fielding for his personal commitment and dedication in seeking to acquire statutory regulations for his profession. I also thank officials of the Department of Health, whose contributions have been invaluable.
I wish the Bill a speedy passage through the other place, where Lord Walton has agreed to take it on. I hope that their Lordships do not wish to amend the Bill, which has already been amended and has 42 clauses. I think that we have done the job properly, and I look forward to the Bill receiving Royal Assent.

Question put and agreed to.

Bill read the Third time, and passed.

Hedgerows Bill

As amended (in the Standing Committee), considered.

New Clause 1

EXTENT OF PROTECTION

'.A hedgerow is not protected if it does not exceed twenty metres in length unless it forms a junction with another hedgerow at each end.'.—[Mr. Clifton-Brown.]

Brought up, and read the First time.

Mr. Geoffrey Clifton-Brown (Cirencester and Tewksbury): I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker (Mr. Geoffrey Lofthouse): With this, it will be convenient to take the following amendments:
No. 33, in clause 1, page 1, line 5, leave out
'where the conditions in subsection (2) below are satisfied'.
No. 34, in clause I, page 1, line 12, leave out subsection (2).
No. 53, in clause 13, page 8, line 30, at end insert—
'(7A) This Act only applies to a hedgerow if—

(a) it is on or adjacent to land used for agriculture or forestry or is on common land, protected land or a golf-course or racecourse, and
(b) either it is 20 metres or more in length or its continuity is broken at each end by a junction with another hedgerow.

(7B) Regulations may amend the length referred to in subsection (7A)(b) above'.

Mr. Clifton-Brown: On a point of order, Mr. Deputy Speaker. The Bill was debated at great length in Committee, when we had four sittings and discussed it in detail. We are to discuss it further today. Amendment No. 5, which is extremely important, was debated in Committee and withdrawn. It is a great disappointment to all Conservative Members, who wish to ensure that the Bill is workable for those who have to implement it, that amendment No. 5, ensuring that agricultural needs are taken into account—surely, a primary need—has not been selected. I appeal to you, Mr. Deputy Speaker, to consider selecting that most important amendment, even at this late stage.

Mr. Deputy Speaker: The hon. Gentleman may appeal, but he will not be successful.

Mr. Michael Jopling: On a point of order, Mr. Deputy Speaker. I should like to draw your attention, to another aspect of Madam Speaker's selection of amendments—amendment No. 15. At present, it is listed with amendment No. 42. While you may care for a few more minutes to consider the matter before giving your judgment, when you look carefully, you will see that it has been wrongly grouped with amendment No. 42. It falls more naturally with amendments Nos. 44 and 45, to which it relates. You may care to consider the matter for a few minutes as the debate proceeds and state later whether you agree. It would be for the convenience of the House if you could do so.

Mr. Deputy Speaker: I shall give consideration to the matter and give my judgment in a few minutes.

The Minister for the Environment and Countryside (Mr. David Maclean): Further to the point of order raised by

my hon. Friend the Member for Cirencester and Tewkesbury (Mr. Clifton-Brown), Mr. Deputy Speaker. If he can find some method—in order, of course—of obliquely referring to the problem, I might be able to give some helpful guidance.

Mr. Clifton-Brown: In view of what the Minister has said, may I renew my plea that you, Mr. Deputy Speaker, should consider calling amendment No. 5 for us to debate at an appropriate moment?

Mr. Deputy Speaker: I am afraid that I cannot give further consideration to that issue.

Mr. Clifton-Brown: When debating new clause 1 it is essential to discuss how we have arrived at this stage. We had some lengthy and detailed discussions of the Bill in Committee. It might be thought that the concept of hedgerows is a simple one and that to draft a Bill to preserve a hedgerow might be a relatively easy task. However, once we began to discuss the details of drafting such a Bill, we understood how complicated some of the aspects were—as we shall no doubt discover later today.
In Committee, we examined clause 6 in great detail, as it was almost unintelligible as drafted. I shall remind the House of what the original clause 6 was designed to achieve. The Bill provides for someone to notify the local authority if he or she wishes to remove a hedgerow on specified grounds. The local authority then has to decide within 28 days whether to issue a notice preventing removal of the hedgerow. Then there are the usual appeal procedures, after which an enforcement notice may be issued and people can appeal to the Secretary of State to have the notice revoked in whole or in part.
The amendment to clause 6 tabled in Committee was designed to impose de minimis requirements for hedgerow length. It sought to remove the cover provided by the Bill for all hedgerows under 20 m. The problem was that it was drafted in such a convoluted way that the Committee could not agree to it and decided to chuck it out, leaving us with the problem that the Bill now covers every single shrub in every field in the country.
We spent almost a whole sitting debating whether small bits of urban hedgerows should be brought within the scope of the Bill and we decided, given the burdens that that would impose on local authorities, that the Bill would become unworkable if we included those bits. If we include all hedgerows under 20 m the same will happen.

Mr. Peter Atkinson: Can my hon. Friend confirm that a minimum of 20 m is at least consistent? That was the very distance included in the report to the Department of Environment by the Institute of Terrestrial Ecology, as the minimum length of boundary to be classified as a hedge.

Mr. Clifton-Brown: Indeed. The new clause also specifies 20 m—a sensible length, and hedgerows less than 20 m should not be protected. If we start protecting tiny bits of hedgerow, the measure will become over-bureaucratic and an administrative nightmare for local authorities.

Lady Olga Maitland: In my urban constituency there are many little hedgerows around golf courses, behind parks and surrounding all sorts of public buildings. Surely they, too, deserve protection, even though they are not 20 m long?

Mr. Clifton-Brown: That backs up what I have been saying. In Committee, we decided that however worthy these small bits of hedgerow might be, bringing them within the scope of the Bill would wreck it, because it would become unworkable and over-bureaucratic. Local authorities would be swamped by thousands of inquiries about the hedges in people's gardens.
We must try to make the Bill workable, particularly for the agricultural community, on which the major burden will fall. My new clause is a simple way round the problem. It exempts all hedges under 20 m unless they form an H-type junction between two other hedgerows.
Amendments Nos. 33, 34 and especially No. 53 go a long way towards meeting my anxiety and I am grateful to my hon. Friend the Member for Surrey, East (Mr. Ainsworth) for that. I submit, however, that new clause 1 is a far better way forward.

Mr. Peter Hardy: I shall try to be brief, because brevity is necessary if the Bill is to be enacted. I strongly support the Bill although its promoter is aware that I regard it as inadequate. However, the situation in Britain is such that a Bill of this sort is desperately needed.
The Government have proclaimed their support for the Bill in recent months and have used it as evidence of the green commitment of the Conservative party. There is not much of a commitment in evidence today, as Member after Member is queuing up to stop the Bill becoming law. I trust that the Conservative party will shelve any claim to green virtue.
If the Bill is to have any chance at all, Conservative Members will have to withdraw their amendments or merely move them formally. If they do not do that but drag out the time of the House to prevent the Bill from becoming law, they will have added shame to the ignominy of their record on this matter over the past 15 years.
The hon. Member for Cirencester and Tewesbury (Mr. Clifton-Brown) says that his new clause is designed to allow the removal of 20 m hedgerows, but Conservative Members are trying to make sure that the Bill does not provide protection for any hedgerow. I will give one example of why the new clause is undesirable. Many short hedgerows would probably have been removed in the past 15 years or more if they did not serve a purpose, so extensive has the destruction of hedgerows been. If a 20 m hedgerow contained a rare species of flora or fauna there would be no opportunity to ensure its survival.
Some species of flora in our country can be numbered on the fingers of one hand, and if the last half dozen of a plant species is contained in a 20 m hedgerow, that species would eradicated because the hon. Member for Cirencester and Tewkesbury does not think that any 20 m stretch of hedgerow is worth keeping.

Mr. Jopling: If the flora were as important as the hon. Gentleman suggests, it is more than likely that its habitat would be protected as a site of special scientific interest. That is a much more satisfactory way to preserve our heritage of flora. Flora and fauna as important as the hon. Gentleman describes would be better preserved by means of an SSSI than by rejecting the amendment.

Mr. Hardy: In an ideal world the right hon. Gentleman would be perfectly right, but has he not studied the number of sites of special interest that have been destroyed in recent decades? The number is well over 1,000, and probably over 2,000 or 3,000. Those who are interested in

conservation welcome the conferring of the status of SSSI on a specific habitat, but they have no confidence that under this Administration such habitats enjoy any protection at all. What the right hon. Gentleman and his hon. Friends have been about this morning is further evidence that while the Conservatives are in office, Britain's ecological inheritance is very much under threat.
I welcome the fact that the Government have supported the hon. Member for Surrey, East (Mr. Ainsworth) in his attempt to get this inadequate measure on to the statute book, but I deplore the tactics adopted by Conservative Members who have tabled amendment after amendment, all of them designed to do nothing other than to remove any meaning from hedgerow protection.

Mr. Peter Atkinson: Will the hon. Gentleman give way?

Mr. Hardy: No, I will not. The hon. Gentleman has wasted enough of my time this year already.
If Conservative Members wish to understand why the Conservative party is unpopular, they should consider the vast number of discreditable amendments that they have tabled. I sought hedgerow protection through the Wildlife and Countryside Act 1981 when it was being debated, but I was blocked by the Government. After that, I tabled a number of hedgerow Bills, the first of them in 1982. In 1982, the Government said that we did not need a hedgerow protection Bill because destruction had virtually stopped. Since then we have lost 100,000 miles of hedgerow and the Government have sat by year after year, watching.

Mr. Clifton-Brown: Will the hon. Gentleman give way?

Mr. Hardy: No I will not give way, for the same reason that I would not give way to the hon. Member for Hexham (Mr. Atkinson). I am not often discourteous, but I am discourteous about hedgerows because I have every reason to be angry.
In 1987, I was on the council of the Royal Society for the Protection of Birds. I went to King's Cross station on the day that the RSPB celebrated its centenary to see a railway engine named Avocet to commemorate that anniversary. The guest speaker was the then Mrs. Thatcher, who made a speech in which she said that it was deeply regrettable that 130,000 miles of hedgerow had disappeared in Britain over the past three decades. She called for hedgerows to be protected. I left that gathering to come to the House to present yet another Bill on hedgerows. On the Friday of the following week, when I sought Second Reading for that Bill, the Government blocked it—on the orders of that right hon. Lady.
I had hoped that the Government had learnt some sense as some Ministers were saying, "Yes, we need to be green; we need to protect hedgerows." Hence, the hon. Member for Surrey, East was able to present his Bill when it was drawn near the top of the ballot and I understood that the Government would support it. However, they were not keen to encourage their Back Benchers to support it. I ask those hon. Members who are responsible for so many of the amendments to have some regard to the position of their Government and the efforts of their hon. Friend and to withdraw their amendments so that the Bill has a chance. If they do not do so, it will fall, we shall have to try again and small hedgerows—

Mr. Clifton-Brown: On a point of order, Mr. Deputy Speaker. The hon. Member for Wentworth (Mr. Hardy) has made a disgraceful slur on Conservative Members, but he will not give way—

Mr. Deputy Speaker: Order. It is up to the hon. Member making the speech whether he wishes to give way, and the hon. Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) knows that. That is not a point of order for me. It is an abuse of the procedures of the House.

Mr. Hardy: The hon. Member for Cirencester and Tewkesbury delayed us a great deal in Committee and we listened to him with courtesy. I regret that the lack of time —time is an important factor—does not justify my giving way.
If the new clause is not withdrawn and if Conservative Members do not withdraw the rest of the amendments, or at least ensure that they are debated briefly, it will be not merely 20 m or shorter hedgerows which continue to be destroyed at an excessive pace, but all other hedgerows. I trust that they will not wish to bear the consequences of their irresponsibility, because it would be irresponsibility if they allowed the Bill to fall and more thousands of miles of hedgerows to go.

Mr. Christopher Gill: Will the hon. Gentleman give way?

Mr. Hardy: No, for the reasons that I have already given. I want to be brief. I said that I would not delay the Bill, and I am conscious of the fact that the hon. Member for Surrey, East may be feeling restive about the scale of my support.
If Conservative Members wish to maintain any reputation for green concern, they should not continue along the route that they have so far adopted. The right hon. Member for Westmorland and Lonsdale (Mr. Jopling), who has already referred to his osteopath, has a high reputation for the work that he did as Minister of Agriculture, Fisheries and Food to secure environmentally sensitive area status. That was an important step. I am amazed that the reputation that he developed is being squandered by his support for amendments and new clauses designed to continue the damage and destruction of the rural and natural heritage of our land.

Mr. Jopling: I am extremely disappointed with the hon. Member for Wentworth (Mr. Hardy). He and I have had a good many associations over the years, including one particular association in defence, and I am sorry that he should have acted as he did.
The hon. Gentleman began his speech by saying that there was not very much time to deal with the Bill—we have only 76 minutes to deal with a lengthy Report stage —so to take 10 of those 76 minutes himself is a bit rich.
I declare an interest as I am a farmer and a member of both the National Farmers Union and the Country Landowners Association. The hon. Gentleman was kind enough to refer to my work in creating environmentally sensitive areas. Indeed, I was the first Minister to make public money available for the planting of new hedgerows. I am proud of that.
I declare my interest even more fully by informing the House that I have several miles of hedgerow on my farm. During the past year or two we have allowed most of the roadside hedgerow to grow upwards by several feet, as recommended by the conservation bodies, to encourage

wildlife in the hedges. The hon. Gentleman is most welcome to come to my farm and see what we have tried to do, both by making our hedgerow bigger and thicker and by encouraging wildlife through our conservation interest.
It is unfortunate that the hon. Gentleman has chosen to take the position that he has. I am all for preserving hedgerows and making them better as wildlife habitats, but we must try to be fair. All the amendments to which I have put my name have been recommended by the NFU and CLA, in an attempt to make the Bill a fair balance between the natural desire of the overwhelming majority of farmers and landowners to preserve our heritage and hedgerows and the necessity to protect the livelihoods of many thousands of people. It is strange that the hon. Gentleman wanted their views to be swept away in 76 minutes, which is a wholly inadequate time for sensible discussion on an important Bill.
The hon. Gentleman rejected both new clause 1 and amendment No. 53 tabled by my hon. Friend the Member for Surrey, East (Mr. Ainsworth). In fact, I do not think that that amendment goes far enough and I hope that my hon. Friend will agree to withdraw it and also to accept new clause 1. We are attempting to make the Bill fair between those who wish to conserve and protect the countryside, and our hedgerows in particular, and those who see the countryside as their workshop and a means of livelihood for many thousands of people.

Mr. Peter Atkinson: I want to rebut some of the comments that the hon. Member for Wentworth (Mr. Hardy) directed at me and some of my hon. Friends. First, I declare an interest as I am a member of both the Country Landowners Association and the British Field Sports Society. We place a high regard on hedgerows as an important reservoir for game conservation. It is important that the Bill should be seen to be fair. My hon. Friend the Member for Surrey, East (Mr. Ainsworth) thought, no doubt, that this would be a simple matter, but it has turned out to be a very complicated matter because the British countryside is complicated and throws up many different problems which nobody envisaged when the Bill began its passage through Parliament.

Mr. Gill: As my hon. Friend said, these are very complicated matters. I have suggested to him in the past that when we legislate, the effect of the legislation that we pass is often the very opposite of that which was intended. He may be interested in the contents of an unsolicited letter that I have received from one of my constituents who, among other things, says:
I have embarked on a 2–3 years hedge planting programme—There could be no greater disincentive for me to complete what I already have in mind or even extend my existing programme than the prospect of a conservationist or bureaucrat cashing in on my efforts".

Mr. Atkinson: I agree with my hon. Friend. That is one of the problems with legislation of this kind. It persuades people, farmers in particular who have planted new hedges, that they will, as it were, be set in stone for ever and that no regard will be paid in future to the agricultural requirements of the farm.

Mr. Peter Ainsworth: I can assure my hon. Friend that I never thought for one moment that this would be a simple matter. It is a complex matter. I agree with those hon. Members who have said as much.
However, that does not mean that this matter cannot be dealt with expeditiously, a point which I hope the House will bear in mind today. Can my hon. Friend tell me precisely what the points that he is addressing have to do with new clause 1?

Mr. Atkinson: I shall endeavour to be brief, but I thought that I ought to rebut some of the accusations that have been made. New clause 1 is about simplicity and clarity. That is what we are aiming for in the new clause. I do not intend to detain the House for much longer, but I want to rebut the criticisms of the hon. Member for Wentworth.
The whole debate has been clouded by lack of clarity—by people and pressure groups outside the House who have used the Bill as a method of embarking upon a campaign of farmer bashing. That is why the Bill is such a sensitive issue, a point which is highlighted in the publicity for the Bill. There have been allegations, repeated today by the hon. Member for Wentworth, that many miles of hedgerows have disappeared.
If the hon. Gentleman had taken the trouble to read the report of the Institute of Terrestrial Ecology which was prepared for the Department of the Environment, he would have seen that it talks about the number of hedgerows that have been lost. When the institute talks about hedgerows having been lost, that does not mean that they have been grubbed up and wiped away. All it means is that there has been a change in the management regime for those hedgerows.
We know from the classifications in the report of the Institute of Terrestrial Ecology that the classification of a "hedgerow" is one that is stockproof to sheep. If a farmer no longer keeps sheep and grows cereals, as many of them now do, there is no need for his hedgerows to be stockproof to sheep. They grow out and become more "gappy". Under the Institute of Terrestrial Ecology's classification, that does not amount to a hedgerow. Nevertheless, it is an important and valuable landscape feature in the countryside. It is not lost.

Mr. Peter Ainsworth: I am still slightly lost as to how this point relates to new clause 1. If my hon. Friend is interested in clarity, will he confirm that the Institute of Terrestrial Ecology figures suggest that some 12,300 miles of hedgerows were lost between 1984 and 1990, which amounts to an average of 2,000 miles every year, and that since the Bill was first introduced some 660 miles of hedgerows have been lost?
That equates roughly to the distance between London and John o' Groats. Would my hon. Friend like to comment on the ITE statistics?

Mr. Deputy Speaker: Order. I have been rather lenient with hon. Members on both sides of the House who have spoken so far although they have been going wide of the new clause. If we can return to the new clause, it would help the debate.

Mr. Atkinson: Would you, Mr. Deputy Speaker, give me a second's more latitude to reply to the point made by my hon. Friend the Member for Surrey, East? He failed to understand or to hear what I said. The hedges are not lost, but simply moved to a different category. If my hon.
Friend finishes reading the report and looks at paragraph 24, he will see that only 9·5 per cent. of hedges in that period were lost and that most of those were lost to urban development and to road building. The loss was not the responsibility of farmers, who have continued to plant more hedges.

Mr. Chris Smith: Will the hon. Gentleman accept that the ITE report shows that over that period, the 12,300 miles to which his hon. Friend the Member for Surrey, East (Mr. Ainsworth) referred were lost due to removal—not to neglect, to different management or to the creation of gaps? In addition, 37,100 miles were lost due to neglect. His hon. Friend was talking of the deliberate removal of hedgerows—the problem that the Bill seeks to redress.

Mr. Atkinson: At the risk of trying your patience further, Mr. Deputy Speaker—I shall endeavour not to —may I reply to the point made by the hon. Member for Islington, South and Finsbury (Mr. Smith)? Neglect does not necessarily remove a valuable landscape feature. It simply means that a hedge is no longer kept to the standard of being stockproof for sheep. The fact that it can have gaps and that trees can grow enhances the value of the landscape. If the hon. Gentleman took the trouble to talk to people from organisations such as the Game Conservancy and the Royal Society for the Protection of Birds, he would be told that wildlife benefits from a variety of natural features. Those organisations do not want all the hedges to be neatly clipped and stockproof for sheep; they want a variety of features. I urge the House to support the new clause because it seeks clarity in at least specifying what is a hedgerow.

Mr. Tam Dalyell: I am dumbfounded. I understood that the Royal Society for the Protection of Birds, among others, very much wanted the Bill. Being acrimonious serves no purpose, but I have one point to make to the Minister. There is a general impression among interested people—there are a heck of a lot of those—that a new Member, the hon. Member for Surrey, East (Mr. Ainsworth), has made a serious, competent and good-hearted attempt to introduce hedgerow legislation. For the past few months, I and many others have been under the impression that the Bill would have a safe passage, that debates would be no more than a formality and that the Bill had the Government's backing. Ministers give the impression on the airwaves that the Bill will be passed and I have even heard some of them take credit for the Bill. They say that of course they will do something about hedgerows. It is shameful that, after the efforts of the hon. Member for Surrey, East and others, the Bill will obviously not reach the statute book.
I intend to raise two issues on the new clause, the first of which is the question of very short hedgerows by the roadside. I quote my friend Dr. David Long of the botanic gardens in Edinburgh who says:
Hedgerows are not only still being grubbed out in southern Scotland—but are being insidiously killed by salt-spray (eg A68 south of Edinburgh) and over-zealously pruned to the extent that their value as shelter and food for birds is severely restricted. Polluters do not pay! When hedges are destroyed by car-accidents (also many places on A68) they are rarely restored, unlike walls.
There are many short hedgerows in this country. Are we saying that they are not worth keeping?
There is a strong argument for doing something about short hedgerows and for using the set-aside scheme to build up set-aside areas on the verges of many of our busier roads which we insist on salting.
Secondly, could we consider the question of hedges measuring less than 20 m in areas affected by opencast coal mining? I have a specific example in mind—the current cause celebre involving Bridge castle near Westfield, in my constituency. It is proposed that, over 82 weeks, some very beautiful countryside—the lungs of the small steel town of Armadale—should be dug up, along with the hedges and beech trees growing on it, so that tens of thousands of tonnes of coal can be mined.
Two issues arise from that. First, should opencast mining be allowed when it involves the destruction of hedges, some of them very old? Secondly, what is the country thinking of in allowing opencast mining in such areas, when we are at our wits' end trying to decide what to do with our deep-mined coal?
I hope that, as a former Scottish Whip, the Minister will bring the matter to the attention of the Scottish Office. It is not that West Lothian district council is either unwise or ill hearted; it is very likely to give permission, but I understand why. It is nothing to do with the council's judgment about hedges. Nearly all its members—incidentally, it is not Labour controlled—say that they are against the proposal. Why, then, do they think that they may allow it? The answer is simple: legal fees. Because of Government guidelines, the proposition strongly favours the developers. If the developers appeal, legal costs may well be awarded against the council—and lawyers do not come cheap; five or even six figures may be involved.
If hedges measuring less than 20 m are to be protected from the consequences of opencast mining, it must be done through a Bill such as this. Given the legal set-up, the fees involved and local authorities' presumption that they may have to pay costs, such hedges cannot be protected in any other way. I feel passionately about the matter, and I hope that the Minister will contact the Scottish Office on Monday morning.

Mr. Peter Ainsworth: The House may be relieved to learn that I do not intend to deal with all the wide-ranging points that have been made.
The hon. Member for Wentworth (Mr. Hardy) mentioned Government support. The Department of the Environment has provided invaluable help, and its annual report contains a public statement of its support for the Bill. I pay tribute to the work of its officials, and to the assistance of my hon. Friend the Minister for the Environment and Countryside.
The hon. Gentleman also mentioned the attitude of Conservative Members. I believe that an overwhelming number of hon. Members on both sides of the House support the Bill. I know that a small minority do not; as is becoming clear today, it is a fact of parliamentary procedure—albeit, perhaps, a strange one—that a small minority of Members can damage private Members' Bills, but no one outside the House should be under any illusion about the commitment of the majority of Conservative Members to such legislation. I am also aware of the enormous support that the measures command in the country at large.
With reference to what my hon. Friend the Member for Hexham (Mr. Atkinson) said, I have a letter from a number of groups interested in countryside matters,

including the Royal Society for the Protection of Birds, the World Wide Fund for Nature and the Royal Society for Nature Conservation, representing in total a membership of 2 million. The letter, which the RSPB has signed, states:
We believe that the Hedgerows Bill is workable and fair. It would provide sound legislation to protect important hedgerows. It is a vitally important piece of legislation, which will contribute much to the protection of the countryside.

Mr. Peter Atkinson: Let me clarify what I said. I apologise if I implied that the RSPB was against the Bill. I realise that it supports the Bill. I merely said that it believed that variety of habitat was important to wildlife.

Mr. Ainsworth: My hon. Friend was urging hon. Members to listen to what the RSPB had said: I am merely suggesting that he might do the same.
I have considerable sympathy with the sentiments expressed by my hon. Friends. The House will be aware of the dilemma that I have faced throughout our proceedings. The hon. Member for Wentworth (Mr. Hardy) thinks that the proposal does not go too far while other hon. Members, whose views have been well represented in our discussions, take the opposite view. I hope that we are steering a middle course. I have sympathy with the points that have been made.
I undertook in Committee to replace clause 6 with a simpler form of words that would still exempt hedgerows which, by virtue of their size and scale, could be regarded as de minimis. Amendment No. 53 is the result of that undertaking. It would have exactly the same effect as new clause 1. My hon. Friend the Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) said that his new clause I was better than the amendment, but did not attempt to say why. I think that the amendment is better because it is more concise in that it does not require the addition of a clause to the Bill and is tidier in the sense that it ensures that the description of the scope of the Bill will be entirely contained in clause 13. It also ensures that the Secretary of State has the power to change, by way of regulation, the specified length of 20 m, which I hope hon. Members will think is a help. I urge the House to accept the amendment and not new clause 1.

Mr. Chris Smith: We strongly support the Bill. I hoped at the start of today's proceedings that we might by now have been sending it on its way to the other place and that it would reach the statute book. The Opposition chose not to table any amendments on Report because we wanted the Bill to be considered expeditiously. We debated the Bill at length in Committee and felt that that debate had been sufficient.
The hon. Member for Surrey, East (Mr. Ainsworth) has bent over backwards throughout to meet the concerns expressed by hon. Members on both sides of the House. That is why we are happy to accept amendment No. 53 and the associated proposals. We proposed amendments of our own in Committee. It is no secret that we believe that the Bill does not go far enough. None the less, it is the best compromise that could be achieved. The amendments of the hon. Member for Surrey, East reinstate the de minimis 20 m provision which was broadly agreed by both sides in Committee.
Even if we accept those amendments and make more rapid progress on other amendments, I fear that it is the intention of some Conservative Members to ensure that the Bill is talked out today. I hope that in the final 30 minutes available for debate today they will think again


about that, because some 40 miles of hedgerow disappear every week. That is a precious habitat and a crucial part of our landscape. The Bill will go a considerable way towards protecting some of that precious inheritance.
I hope that Conservative Members will not seek, for a variety of reasons best known to them, to ensure that the Bill does not reach the statute book. If they do that, they will have a very heavy conscience to bear in the coming months and years.

2 pm

Mr. Clifton-Brown: It was interesting to hear allegations from the Opposition Front Bench and from Opposition Members that we are deliberately trying to talk the Bill out when Opposition Members have spoken for 17 of the 46 minutes that we have spent debating the Bill. We should bear that in mind.

I beg to ask leave to withdraw the new clause.

Motion and clause, by leave, withdrawn.

Clause 1

OFFENCE OF UPROOTING ETC. HEDGEROW

Amendment made: No. 33, in page 1, line 5, leave out
'where the conditions in subsection (2) below are satisfied'.—[Mr. Peter Ainsworth.]

Mr. Clifton-Brown: I beg to move amendment No. 1, in page 1, line 6 after 'person', insert 'intentionally'.

Mr. Deputy Speaker: With this, we may take amendment No. 35, in page 1, line 22 leave out from 'that' to the end and insert
'he took all reasonable measures to prevent the hedgerow being uprooted or destroyed or, as the case may be, the quality of the hedgerow being significantly impaired'.

Mr. Clifton-Brown: I am in error. I should have declared the fact that I am a farmer. Over the past 20 years, I have had a net gain on my farm of more than one mile of hedgerows. I would not like anyone to think that I do not have an excellent record on hedgerows. I am also a member of the Country Landowners Association, the National Farmers Union and the Council for the Protection of Rural England.
Amendment No. 1 strikes at the heart of the Bill. What is the motive behind the proposal? The matter is highly subjective, but I submit that the local authority, when deciding whether to issue an enforcement notice under the Bill, should have to prove intent. It is a fundamental tenet of the criminal justice system that a person is innocent until proven guilty. It would be rather draconian for the Bill to reverse that trend.
As I said in Standing Committee, there is precedent for the word "intent" in other legislation. Section 1 of the Wildlife and Countryside Act 1981 includes the word "intent". It states that it is a substantial Act which covers many rural issues and it makes it an offence to damage "intentionally" the nest of a wild bird. Therefore, the concept of consent is understood by the courts and by the rural community. It would be an appropriate word to use in the Bill. There are other statutory precedents. The Badgers Act 1991, as consolidated by the 1992 legislation, contains the word "intent".
As for amendment No. 39, my hon. Friend the Minister has recognised that we must look carefully at what the

intention was. Although he has not used the word "intent", he has come some way between the Bill as originally drafted and amendment No. 1. Amendment No. 1 is much fairer on the farming community, which will have to implement the Bill. Authorities, when deciding whether to issue an enforcement notice or proceedings against an offender, should have to prove intent, in common with all other tenets of the British justice system.

Mr. Peter Ainsworth: Again, I am sympathetic to the general point. It occurs to me that the notion of strict liability, which is incorporated in the Bill as it stands, seems somewhat harsh in the circumstances, but I cannot recommend to the House amendment No. 1, which would make it necessary to prove intent. It would be too difficult for successful prosecutions to be undertaken. It naturally follows that I believe that amendment No. 1 would severely impair the effectiveness of the Bill.
I have therefore brought forward amendment No. 35, which I commend to the House. It creates the defence of having taken all reasonable measures to prevent the destruction of or damage to a hedgerow. There is still the onus to take due care when working in the vicinity of hedgerows, but allowance is made in amendment No. 35 for cases of genuine accident to be argued.
That is a fair arrangement which will nevertheless retain the effectiveness of the Bill as a deterrent against the careless treatment of hedgerows. That is why I ask for amendment No. 1 to be withdrawn and for amendment No. 35 to be accepted.

Mr. Clifton-Brown: I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendments made: No. 34, in page 1, line 12, leave out subsection (2).

No. 35, in page 1, line 22, leave out from 'that' to the end and insert
'he took all reasonable measures to prevent the hedgerow being uprooted or destroyed or, as the case may be, the quality of the hedgerow being significantly impaired'.—[Mr. Peter Ainsworth.]

Clause 2

PERMISSION BY NOTIFICATION

Mr. Peter Atkinson: I beg to move amendment No. 2, in page 2, line 12, leave out
'(or work including the work)'
and insert 'or works'.

Mr. Deputy Speaker: With this it will be convenient to consider the following amendments: No. 36, in page 2, line 12, leave out
'(or work including the work)'.
No. 3, in page 2, line 16, leave out
(or work including the work)'
and insert 'or works'.
No. 37, in page 2, line 16, leave out
'(or work including the work)'.
No. 38, in page 2, line 34, after first 'work' insert
'specified in the notice under subsection (2)(a) above'.

Mr. Atkinson: When I tabled my amendment, I had not seen the amendment that was subsequently tabled by my hon. Friend the Member for Surrey, East (Mr. Ainsworth). Hon. Members will remember that there was an effort to get some plain English into the Bill. I am glad


that my hon. Friend the Member for City of Chester (Mr. Brandreth) is present, because he has an enormous interest in this subject. We felt that the phraseology in clause 2
to carry out the work
and
(or work including the work)
was absolutely baffling. The farming community has to deal with some difficult and complicated forms, which I shall call IACS forms. They have set a good example of how to clarify a simple subject. I am glad that my hon. Friend's amendments simplify the Bill to make it better understood by those who will have to live with it should it become law. Having seen the other amendments, I do not propose to push amendment No. 2. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Amendments made: No. 36, in page 2, line 12, leave out
'(or work including the work)'.
No. 37, in page 2, line 16, leave out
'(or work including the work)'.
No. 38, in page 2, line 34, after first 'work' insert
'specified in the notice under subsection (2)(a) above'.

Mr. Jopling: I beg to move amendment No. 4, in page 2, line 37, leave out from 'are' to end of line 40 and insert 'that—

(a) the hedgerow makes a significant contribution to the landscape,
(b) the hedgerow is of significant historic interest, and
(c) the hedgerow is of significant value as a habitat for plants or animals.'.

Mr. Deputy Speaker: With this it will be convenient to take amendment No. 39, in page 2, line 37, at end insert 'that in the opinion of the local planning authority it is of significant value by reason of.

Mr. Jopling: I notice that the hon. Members for Wentworth (Mr. Hardy) and for Linlithgow (Mr. Dalyell), who spoke for 15 minutes in the earlier debate, are no longer with us. I do not intend to keep the House for long. I hope that my hon. Friend the Member for Surrey, East (Mr. Ainsworth) who is promoting the Bill, will accept what I regard as important amendments to clause 2(4), which deals with some of the criteria that should be used when a local authority decides whether any alteration to a hedgerow should be made.
As the Bill is drafted, it is all rather bald, if I may use that phrase. It says that the grounds to be considered are

"(a) the contribution of the hedgerow to the landscape,
(b) the historic interest of the hedgerow, and
(c) the value of the hedgerow as a habitat for plants and animals."

I am sure that my hon. Friend would agree that any hedgerow makes a contribution to the landscape in the same way as any hedgerow that has existed for more than a year or two could be said to have an historic interest if it appears on a map from earlier times, however recent.
Of course, it could be said that any hedgerow has value as a habitat for plants and animals. I cannot think of a hedgerow anywhere that is not sometimes a habitat for plants and animals. We must be a little more specific. Amendment No. 4 adds the word "significant". We should fine down the definition so that the more important hedgerows are preserved and the bureaucratic process for the preservation of hedgerows is not embarked upon unless the hedgerows make some significant contribution, have some significant historic interest or are of significant value as a habitat for plants and animals.
It is essential that we strengthen the Bill. I know that my hon. Friend the Member for Surrey, East has tabled an amendment to meet the point, but he will agree that the words that he proposes in his amendment No. 39, which we are also discussing in this group, are not so clear as the ones that we have proposed. He proposes that we should use the opinion of the local planning authority on whether the hedgerow is significant. I speak as a former member of a planning authority in North Yorkshire. I should be the first to admit, and anyone who has served on a planning authority would be forced to agree, that sometimes the opinions of planning authorities are somewhat eccentric. Often one can make comparisions between one planning authority which agrees to one thing and another which would turn it down.
We want to create greater uniformity in the treatment of hedgerows. Therefore, the less that we talk about the opinion of planning authorities and the more that we write into the Bill that the contribution, interest or value of the habitat should be significant in the broader sense, the better. That brings me back to my earlier comments about the importance of making provisions for the preservation of hedgerows fair to everyone—those who are principally concerned with conservation and those who are principally concerned about using the countryside as a workshop and a means of livelihood.

Mr. Peter Ainsworth: My right hon. Friend is a highly distinguished former member of the Cabinet and former Minister of Agriculture, Fisheries and Food. He will be as aware as anyone in the House of the value of guidance notes that accompany legislation. Why does he not think that, in this case, guidance notes will provide the suitable background against which local authorities may take their decisions?

Mr. Jopling: I always prefer to see an undertaking included in a Bill rather than in guidance notes that emanate from a Department. The House legislates in a far better manner if it makes it clear in a Bill what it wants rather than leaves it to some sort of guidance that comes filtering out from Departments. I often find that such guidance does not clarify the situation. I therefore hope that my hon. Friend will agree to the amendment, which is a significant improvement on his amendment No. 39. I should be most grateful if he could accept it.

Mr. Maclean: I had not intended to speak much in this debate because my hon. Friend the Member for Surrey, East (Mr. Ainsworth) has made an excellent job of masterminding the Bill through the House and there is no real job for me to do. I should like to make a brief contribution, however, about guidance notes.
As with any new legislation, the guidance issued by the Secretary of State on the interpretation of the Hedgerows Bill will be extremely important. I intend that that guidance will be comprehensive and I intend it to cover many aspects of the forthcoming Act. As I said in Committee, I do not want those guidance notes to comprise a couple of flimsy pages; I want them to make a good, readable tome—a best seller—on all aspects of hedgerow management.

Mr. Hardy: In that guidance will the Minister make clear what was confirmed in Committee: that the Bill in no


way weakens the protection afforded by enclosure legislation, where specific requirements were laid down for the preservation of hedgerows?

Mr. Maclean: I did not intend to include that confirmation in the guidance, but there would be no harm in repeating what we said so often in Committee—the Bill has no connection with that previous legislation.
Three important areas would be covered by the guidance, including the landscape, wildlife and historic criteria and the system for applying those when making judgments on hedgerows notified to local authorities. That guidance would also include the importance of viewing the notified hedgerow in the context of all the hedgerows and, for example, the importance of taking into account the relevance of recently planted hedgerows for the landscape and wildlife value of surrounding hedgerows.
We intend to take the views of experts on the countryside and go out to consultation. We have started that process and we will continue it as we develop the criteria into a system for application. We will undertake a trial of any such system. I therefore believe that there will be plenty of opportunity for informed and interested parties to play a role in developing the guidance.
We also intend that the guidance will address what exactly is likely to be covered by the term, proper management of a hedgerow. I hope that that will take into account different management practices in different parts of the country. I do not just hope that; I intend that it shall.
The guidance notes will also need to give advice on planting and replacements with respect to any duty to reinstate a hedgerow. We considered this matter in Committee and it is important that we cover it in the guidance. In particular, that guidance should emphasise that appropriate species should be chosen when replacing a hedgerow in replanting. It would also need to make it quite clear that one should not expect a farmer to replace a hedgerow with large hedgerow-grown container plants or large shrubs. That may seem self-obvious to all hon. Members, but the matter was raised in Committee and I should like to nail it once and for all. The list is by no means exhaustive, but I hope that it will help to reassure hon. Members that we recognise the important role that guidance can play, and intend it to be comprehensive and to cover all those items that it would be inappropriate to place in the Bill.
I say to the hon. Member for Linlithgow (Mr. Dalyell) that the Government have attempted to give all possible help, within the lines of propriety, to my hon. Friend the Member for Surrey, East. I have repeatedly said that we support the Bill. However, the Bill is complex, and we found some more complexities as we analysed it in Committee. I respect the right of hon. Members to table amendments and improve the Bill. My hon. Friend sensibly tabled amendments which I commend to the House—it is now a far better Bill than it was initially. One thing that I cannot do in relation to a private Member's Bill, even as a former Whip and even when I support the Bill, is to try to whip hon. Members on either side of the House to support it, as that would be quite inappropriate.

Mr. Clifton-Brown: Accusations have been made about Conservative Members. It should therefore be made clear

that nearly every time amendments were tabled, my hon. Friend the Member for Surrey, East (Mr. Ainsworth) then drafted another amendment designed to make a compromise between the Bill as originally drafted and other hon. Members' amendments. I am grateful to my hon. Friend for doing that. We were not merely trying to waste time by tabling the amendments.

Mr. Chris Smith: If that is so, in the next five minutes will the hon. Member accept all the amendments tabled by his hon. Friend to meet the issues that he and his hon. Friends have raised so that the Bill can go on its way?

Mr. Clifton-Brown: I take the hon. Gentleman's point, but amendment No. 4, which I am about to discuss, is the fundamental amendment. I think that my hon. Friend the Member for Surrey, East would accept that his Bill was not designed to protect every hedgerow, but only specific categories of hedgerow. Any well-meaning person would accept that. The Bill was designed to protect hedgerows of historic value or of value to the landscape or with significant habitat qualities, and it is in that spirit that I wish to speak to the amendment.
We want to make the Bill as clear as possible for all those who are asked to implement it and for local authorities who are asked to police it. I accept my hon. Friend the Minister's assurance that the issues will be covered in the guidance—we had many similar discussions in Committee—but I believe that amendment No. 4 clarifies what is expected and I urge hon. Members to consider it carefully.

Mr. Peter Ainsworth: I have listened with great care to my right hon. Friend the Member for Westmorland and Lonsdale (Mr. Jopling), my hon. Friend the Minister and my hon. Friend the Member for Cirencester and Tewkesbury (Mr. Clifton-Brown), and I have been more persuaded by the arguments of my hon. Friend the Minister than by those of my other hon. Friends.
It has always been my intention to protect only those hedgerows that are of value—I never intended my Bill to protect all hedgerows. It was in response to the unease expressed by some of my hon. Friends in Committee, who felt that the Bill would not achieve that aim, that I tabled amendment No. 39.
I submit that amendment No. 39 has precisely the same effect as amendment No. 4 and I urge hon. Members to consider the role of the guidance notes to which the Minister has referred. On that basis, I urge the House to reject amendment No. 4 in favour of amendment No. 39.
As for the wider issue, the tabling of amendments, I do not for one moment suspect that the amendments that have been so persistently tabled in Committee and on Report are ill intentioned. It is true, as the Minister said, that the Bill has emerged a better Bill as a result of the close scrutiny exercised by hon. Members with differing points of view, and I am grateful to those who have played a constructive role in bringing the legislation thus far.
Nevertheless, we have to accept that the amendments tabled for today will ensure that the Bill fails at this stage. I thank all who have been involved and, in view of the enormous support for the Bill in the country and the House, I stress that this is not the end of the road for hedgerows. We now have the basis for some excellent legislation to protect Britain's most valuable hedgerows, and I still look forward to the day when the legislation will be in place to do that important job.

Mr. Jopling: I pay tribute to my hon. Friend for his generous comments. Although I strongly prefer amendment No. 4 to amendment No. 39, I recognise that on this and other occasions my hon. Friend has done his best to meet our points. I am therefore perfectly happy to withdraw amendment No. 4 on the understanding that the House agrees to amendment No. 39.
I recognise that 76 minutes is far too short a time properly to deal with an important Bill of this sort, to which 14 groups of amendments have been tabled, and it was inevitable that the Bill would not complete its Report stage in view of the shortage of time.
I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment made: No. 39, in page 2, line 37 at end insert
'that in the opinion of the local planning authority it is of significant value by reason of'.—[Mr. Peter Ainsworth.]

Clause 5

CATEGORIES OF PERMITTED WORK

Mr. Peter Atkinson: I beg to move amendment No. 8, in page 4, line 40 at end insert—
'(bb) uprooting or otherwise destroying, or significantly impairing the quality of, a stretch of hedgerow for the purpose only of carrying out remedial work to a ditch,'.

Mr. Deputy Speaker: With this it will be convenient to discuss also the following amendments: No. 40, in page 4, line 46 leave out from 'hedgerow' to 'and' in line 48 and insert
'for the purpose only of protecting any crops growing on adjacent land from any pests or diseases injurious to them'.
No. 31, in page 4, line 48 after 'land', insert
'or livestock depastured on that land,'.
No. 9, in page 4, line 48 after 'land', insert—
'(dd) uprooting or otherwise destroying, or significantly impairing the quality of, a stretch of hedgerow which is harbouring pests that are causing serious damage to crops growing on adjacent land, or to livestock depastured on that land,'.
No. 30, in page 4, line 48 after 'land', insert—
'(dd) significantly impairing the quality of a stretch of hedgerow which is harbouring pests that are causing serious damage to crops growing on adjacent land, or to livestock depastured on that land,'.
No. 41, in page 5, line 5 at end insert—
'Regulations may make such amendments of section 6 of this Act as appear to the Secretary of State to be necessary or desirable in consequence of any provision made by virtue of subsection (2) above'.
No. 43, in clause 6, page 5, line 17, leave out from 'protecting' to end and insert
'any crops growing on adjacent land from any pests or diseases injurious to them'.
No. 56, in clause 15, page 10, line 7 at end insert—
'() " Pest" has the same meaning as in the Plant Health Act 1967'.
No. 27, in page 10, line 7 at end insert—
'(6A) "ditch" has the same meaning as in section 28 of the Land Drainage Act 1991.'.
No. 28, in page 10, line 13 at end insert —

'(7A) "Remedial work" has the same meaning as in section 28 of the Land Drainage Act 1991.'.

Mr. Atkinson: This great rack of amendments has to do with hedging and ditching. We believe that certain hedges or parts thereof should be capable of removal without the farmer being forced to go through the long and tedious process of notification. One aspect concerns clearing ditches in which shrubs can grow up. A second aspect concerns the removal of shrubs to protect crops and livestock from damage.
The amendments tabled by my hon. Friend the Member for Surrey, East (Mr. Ainsworth) go a considerable way in our direction in respect of diseases in hedges that can affect crops, but he has not dealt with the type of shrubs and hedges which can affect livestock. It is that on which I wish to concentrate.
Several plants and hedges can affect livestock—boxbroom, laurel and yew are all poisonous to livestock. Under the Bill, a farmer who wanted to remove yew or broom from a hedge would have to go through the long and cumbersome process of notification. Our amendments deal with such matters as they affect livestock and I commend them to the House.
Drainage operations can be carried out fairly infrequently. In places such as the Somerset levels, the sides of drainage ditches become covered with hedges and shrubs which would ultimately become informal hedges. The problem with the Bill is that unless it is amended to allow drainage operations to proceed, farmers would be impeded and would have to go through the long process of notification before they could start clearing ditches.
It being half-past Two o'clock, further consideration of the Bill stood adjourned.

Mr. Deputy Speaker: Bill to be considered what day? No day named.

Mr. Chris Smith: On a point of order, Mr. Deputy Speaker. We have witnessed the disgraceful spectacle of a small number of Conservative Back Benchers deliberately talking at length about the Osteopaths Bill and tabling a swathe of amendments to the Hedgerows Bill so as to ensure that the Hedgerows Bill will not reach the statute book although the Government support the Bill and it has enormous support outside the House.

Mr. Deputy Speaker: Order. As the hon. Gentleman knows, that is not a matter for the Chair.

Mr. Smith: rose—

Mr. Deputy Speaker: Order. Does the hon. Gentleman wish to make a point of order for the Chair?

Mr. Smith: Yes, indeed. Will the Government ensure that Government time is made available for further discussion of this Bill? If that is not possible, can they include—

Mr. Deputy Speaker: Order. That still has nothing to do with the Chair. No doubt the Government will have noted the hon. Gentleman's comment.

Remaining Private Members' Bills

BAIL (AMENDMENT) BILL

As amended (in the Standing Committee) considered.

Order for Third Reading read.

Bill read the Third time, and passed.

RIGHT TO KNOW BILL

Order for consideration read.

Hon. Members: Object.
Consideration deferred till Friday 14 May.

MEDICINES INFORMATION BILL

Order for further consideration read.

Hon. Members: Object.
Further consideration deferred till Friday 14 May.

VIDEO RECORDINGS BILL [LORDS]

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 2 July.

CRIMINAL JUSTICE (AMENDMENT) (No. 2) BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

CIVIL RIGHTS (DISABLED PERSONS) BILL [LORDS]

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

TRANSPLANTATION OF HUMAN ORGANS BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

ENERGY (FAIR COMPETITION) BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

REPRESENTATION OF THE PEOPLE (AMENDMENT) BILL

Order read for adjourned debate on Second Reading [12 February]

Hon. Members: Object.
Debate further adjourrned till Friday 14 May.

PENSIONS BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

REGULATION OF WHEEL-CLAMPING BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

EUROPEAN UNION (PUBLIC INFORMATION) BILL

Order for Second Reading read.

Hon. Members: Object.
Second Reading deferred till Friday 14 May.

BUSINESS OF THE HOUSE

Ordered,
That, at the sitting on Monday 10th May, the Motions in the name of Mr. John Smith relating to National Health Service may be proceeded with, though opposed, until half-past Eleven o'clock, at which time, unless those proceedings have been previously disposed of, the Speaker shall put the Question already proposed from the Chair.—[Mr. Arbuthnot.]

REINSURANCE (ACTS OF TERRORISM) BILL

Ordered,
That, in respect of the Reinsurance (Acts of Terrorism) Bill, notices of Amendments, new Clauses and new Schedules to be moved in Committee may be accepted by the Clerks at the Table before the Bill has been read a second time.—[Mr. Arbuthnot.]

REINSURANCE (ACTS OF TERRORISM) BILL

Ordered,
That, if the Reinsurance (Acts of Terrorism) Bill is committed to a Committee of the whole House, further proceedings on the Bill shall stand postponed; and that, as soon as the proceedings on any Resolution come to by the House on Reinsurance (Acts of Terrorism) Bill [Money] have been concluded, this House will immediately resolve itself into a Committee on the Bill.—[Mr. Arbuthnot.]

CARDIFF BAY BARRAGE BILL

Motion made, and Question put,
That, at the sitting on Monday 17th May, the Speaker shall put the Question necessary to dispose of proceedings on the Motion moved by Mr. James Arbuthnot on 2nd April relating to Cardiff Bay Barrage Bill not later than half-past Eleven o'clock or one and a half hours after the resumption of those proceedings, whichever is the earlier; and the said proceedings may continue after the expiry of the time for opposed business.—[Mr. Arbuthnot.]

Hon. Members: Object.
Debate adjourned till Monday next.

PARLIAMENTARY COMMISSIONER FOR ADMINISTRATION

Ordered,
That Mrs. Elizabeth Peacock be discharged from the Select Committee on the Parliamentary Commissioner for Administration and Mr. Nirj Joseph Deva be added to the Committee.—[Mr. Arbuthnot.]

Local Government (Touche Ross Report)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Arbuthnot.]

Mr. Tam Dalyell: The passionate opposition to the Government's local government reform proposals in Scotland has more to do with the fact that decision making will be anaesthetised and local government paralysed for five years than it has to do with finance.
The subject of this Adjournment debate is the Touche Ross report on finance. I thought that it was prudent, sensible and well mannered last Friday, as soon as I knew of my luck in getting an Adjournment debate, to let the Government know precisely what I intended to ask, so I hope that their reply will be a considered reply to questions that they have had for a week.
I shall deal first with planning and economic development. Touche Ross has calculated that savings ranging from £58·4 million at the 51 -unit level to £75·1 million at the 15-unit level can be made from planning and economic development.
Given that the Scottish Office calculation of grant-aided expenditure—GAE—for planning and economic development for 1992–93 for both regions and districts is £68·3 million net, will the Minister please explain several matters?
First, how can savings of £75·1 million be made from a combined region and district service costing a net £68·3 million?
Secondly, given that the present planning function is carried out by three islands, nine regions and 37 districts —a total of 49 councils in all—will the Minister please explain how savings of £58·4 million can be made by increasing the number of authorities from 49 to 51?
Thirdly, what are the estimated costs and the nature of the other costs included in this heading and are they normally charged to capital account?
Fourthly, will the Minister please explain how the new unitary planning function is expected to operate with fewer staff than existing regions have at present?
My second subject is library services. Touche Ross has postulated savings ranging from £7·4 million at the 51-unit level to £11·5 million at the 15-unit level for that service, which is presently administered by 41 authorities, and the GAE, as calculated by the Scottish Office, for 1992–93 is £76·1 million. Therefore, will the Minister please explain the following?
First, how can an increase in the number of library authorities from 41 to 51 produce savings of £7·4 million, almost 10 per cent. of the total cost?
Of the total costs for the library service of £76·1 million, it is estimated that £19 million relates to the replacement of books, and so on. The balance of £57·1 million relates to staff and property costs. Therefore, will the Minister please explain how a figure of £21·3 million from a total of £57·1 million—that is; 37 per cent.—could be described as non-operational, that is, managerial?
My third subject is housing. How is it estimated that the total supervision and management costs for the housing service on an all-Scotland basis for 1992–93 amounts to £150 million?
Will the Minister please explain how £38·7 million or 26 per cent. of this total is deemed by Touche Ross to be non-operational?
Fourthly—operational and non-operational costs—for the purposes of the study operational costs were excluded on the assumption that the same quality and quantity of service, together with the same management practices would continue.
The distinction between operational and nonoperational staff is critical to the calculation.
What, therefore, is the breakdown by function of the operational staff and the non-operational staff estimated by Touche Ross reconciled to the total number of local government employees?
It is considered that that information should in fact be readily available.
Fifthly, on staffing structure, the postulated savings are based on a hypothetical model staffing structure for each service. Please supply this for each function, together with a full explanation of the assumptions used in formulating the model structures for the new unitary authorities.
Please explain why, in most options, unitary authorities have been assumed to require less administration and finance staff than existing regions.
Sixthly, on ongoing costs, please explain why Touche Ross treated the costs of information technology, democracy and early retirement pensions as purely transitional and not as ongoing, despite contrary advice from the DOE to the Local Government Commission for England.
Seventhly, on transitional cost—retirement/ redundancy costs, Touche Ross has estimated the number of redundancy/early retirements to vary from 474 at the 51-unit level to 6,633 at the 15-unit level. The costs in year one similarly vary from £16·7 million to £110·4 million.
Given that 26 per cent. of local government employees are aged 50 or over, and given the experience of some English residuary bodies which suggests that redundancy/ early retirement costs could be in the range 1·7 to 2·7 per cent. of revenue expenditure, amounting to £125 million to £200 million, please explain why the figures calculated by Touche Ross are so low.
Finally, on transitional costs—winding up existing authorities, the costs of winding up existing authorities is estimated by Touche Ross to be £88 million over five years before inflation, whereas experience elsewhere would indicate that expenditure on that item could amount to 3·7 per cent. of current expenditure, or £275 million.
As that figure is critical in the costs/savings equation, please say why the figure does not vary across the range of sizes and give the Scottish Office's own estimate of the cost of winding up existing authorities.
I gave notice of those question, and to ensure that the Minister has time to answer I shall now sit down.

The Parliamentary Under-Secretary of State for Scotland (Mr. Allan Stewart): I congratulate the hon. Member for Linlithgow (Mr. Dalyell) on his tenacity in obtaining this Adjournment debate. I listened with the greatest of interest to what he said. As he rightly told the House with his customary courtesy, a few days ago he provided me with a list of the questions that he intended to ask. I shall do my best to answer them.
First, I want to spend a moment or two spelling out the background to the Touche Ross report. Of course, the question of costs in the reform of local government in Scotland is of considerable importance. It has been argued that Touche Ross somehow got its figures wrong and that reform is therefore unaffordable and should not go ahead. There is no basis for those general criticisms and I shall explain why.
The first step that Touche Ross undertook was to gather detailed information about the current management structures in Scottish local authorities. Throughout the costing exercise, it has been assumed that the level and quality of services provided by local authorities would remain constant. It was therefore assumed that there would be no significant change in the numbers of staff directly involved in service delivery. Touche Ross and other commentators have therefore concentrated their analysis on the numbers of managerial and support staff, to which the hon. Gentleman's questions rightly refer.
Touche Ross employed consultants from the Institute of Public Finance to conduct a representative survey of local authorities to establish current management/staffing structures. That work was delayed for a time because of an initial refusal by the Convention of Scottish Local Authorities to co-operate, but finally that information was collected. It is worth pointing out that the survey is the only source of data on management structures across Scotland. Those commenting on the Touche Ross findings have either done so from the viewpoint of their own structure—or, in the case of consultants, the authorities for which they have been working—or have used the Touche Ross figures. Therefore, the Touche Ross figures have been invaluable in that respect.
Essentially, the approach involves comparing the cost of current staffing structures with those which the new authorities might be expected to develop. Because the number of teachers, social workers and others—what one might call the frontline troops—are likely to be unaffected by the boundaries of the new authorities, the methodology concentrates on management staff and other specialists whose jobs will be affected by the structure chosen.
If it is thought that the number of staff in the new structure will be fewer, allowance will have to be made for redundancy and early retirement payments. Similarly, if it is thought that additional staff will be required, the costs of recruitment will have to be included. These initial costs will then have to be compared with the longer term savings that will arise from having fewer staff in the new authorities, in order to arrive at a long-term estimate of the costs and savings arising from the reform.

Mr. Dalyell: Is the Minister happy about the calculations for early retirement? The experience last time was that very many local government employees—often excellent local government employees—could not face up to the hassle of a different structure and therefore took early retirement. In other circumstances, they would have continued with their careers.
If there is another shake up, do the Government understand that many good people will say, "We've had enough. We're not going to live with yet another reorganisation, so we'll take early retirement."? That factor has not been taken into account by Touche Ross.

Mr. Stewart: It has been taken into account. However, the effect on staff morale of another reorganisation and how staff see their future careers developing is an important consideration. That is why I announced to the Convention of Scottish Local Authorities that we had decided to appoint a staff commission to look into these matters, and which will be the subject of the Bill that we hope to put before Parliament next Session.

Mr. Dalyell: My hon. Friend the Member for Monklands, West (Mr. Clarke) has done me the courtesy of coming to sit on the Opposition Front Bench. He is former chairman of COSLA. He knows that, commission or otherwise, the fact is that we have experience of what happened last time. And what happened then is likely to happen again. Talk to local authority employees. There is a great degree of fed-upness.

Mr. Stewart: We shall certainly learn from the experience last time, and from the particular experience last time when a large number of local authority employees found themselves doing essentially the same job within the new structure at substantially enhanced salaries. We shall certainly, under the capping regime, have controls that will affect that. I shall return later to the hon. Gentleman's detailed point, for it relates to the sixth point that he put to the House.
The methodology that the consultants have given us is a valuable tool. The responses to the consultation exercise suggest that it was a sensible approach. Why else, for example, should the City of Aberdeen district council, which is controlled by the Labour party, say, as I told the House on Wednesday, that
the report is the only detailed study available of the likely costs of any reorganisation to a single-tier system … and accordingly the best use possible should be made of it. Many of the cost assumptions which can be checked have been shown not to be unreasonable, whilst further sensitivity analysis has been carried out.
The second task assigned to the consultant—the part that has generated most debate—was to use the methodology to estimate the possible costs of reform for each of the illustrative structures shown in the consultation paper. That refers more directly to the question that the hon. Member for Linlithgow asked. That task required Touche Ross to make a number of assumptions—for example, on the likely staffing structures of the new councils and on the level of redundancy and retirement payments on offer, to which the hon. Gentleman referred. Clearly, no one knows at present what those detailed figures will be. That depends on the shape of the new map and it will be up to the new councils, when they are in place, to take decisions on their staffing levels. Thus, the concept of a right answer to the likely costs is essentially meaningless and generally acknowledged as such.
Before turning to the detailed questions asked by the hon. Member for Linlithgow, I must say that I believe that it was always not only inevitable, but desirable that once the Touche Ross estimates were known, others would react to them. That was precisely our intention in deciding to publish the Touche Ross figures—in full, I reassure the hon. Member for Monklands, West (Mr. Clarke)—last October. The greater the body of evidence that became available—and it became available from a wide range of sources—the more likely we were to be able to assess the likely costs and savings arising from a particular structure. I must emphasise that such an approach implies no criticism of Touche Ross. Rather, it is an extension of its


work. By publishing the consultants' suggestions and by taking note of the comments made on them, we have sought to reach a balanced view of the costs and savings that may emerge.
In practice, our expectations about the likely response to the Touche Ross findings have been entirely borne out. Some people have criticised them as being over-optimistic, some as over-pessimistic. We have had useful discussions with local authority interests and we have had helpful input from professional bodies. All the evidence has been carefully weighed. To suggest, as some people have, that Touche Ross has got things "wrong" is deeply misleading and fails to give due credit to the excellent work of Touche Ross.
The hon. Member for Linlithgow first asked about planning and economic development. The Touche Ross category of planning and economic development also included many staff involved in property services, as well as architects, quantity surveyors and valuers. Those staff made up more than two thirds of the total category. The figures for that grouping are not, therefore, directly comparable with those shown for general aggregate expenditure purposes.
The hon. Member for Linlithgow also asked about planning authorities and how savings could be made by increasing the number of planning authorities from 49 to 51. There are two answers to that question. First, for most of Scotland, moving to an unitary structure means moving from two sets of planners to one set of planners for an existing area. That is likely to lead to economies. Secondly, it does not seem unreasonable that the smaller authorities, implied by the 51-authority structure, might choose to combine similar departments, thus requiring fewer senior managers. That is a general point which the representations that we have received from regions have on the whole avoided and the representations that we have received from districts have generally emphasised. The hon. Member for Monklands, West will, of course, know of the positive reaction from his own area and of the belief by West Lothian district council that it could supply effectively and efficiently a whole range of services under a single-tier structure.
The hon. Member for Linlithgow asked about Library services. That is one of the matters that my officials are examining in the light of comments that have been made. It is worth noting, however, that libraries account for about 2 per cent. of total local authority expenditure: changes to the cost of that service are unlikely to have a marked effect on the overall costs of reform.
The hon. Gentleman also asked about housing. I am not sure of the basis for his figure of f 150 million, but I can tell him that the figures quoted by Touche Ross represent 3·2 per cent. of the total budgeted expenditure on housing for 1992–93. I do not consider that to be an unreasonable level of management and administration spending.
The hon. Gentleman asked about operational and non-operational costs, and suggested that the information on that should be readily available. I assure him that it is readily available. The Touche Ross report shows the number of non-operational staff by function. As the hon. Member for Monklands, West will know, as a former chairman of the Convention of Scottish Local Authorities, the total number of local authority employees according to function is available for the joint staffing watch survey, which is published by the Scottish Office and COSLA.
The hon. Member for Linlithgow asked me to supply the Touche Ross model staffing structures for each service. That information was passed to COSLA earlier this year, and I will arrange for him to receive a copy. He also asked why, in most options, unitary authorities have been assumed to require fewer administration and finance staff than existing regions. That takes us back to a point that I made earlier. It is, of course, a matter for the consultants, but I understand that they decided that the unitary authorities offered scope for rationalisation of some existing staffing structures. That is also the response of a number of individual local authorities of different political persuasions to the consultation exercise.

Mr. Dalyell: There will be a whole mosaic of joint boards. How will they be staffed, and who will pay for them? Has that been taken into account in the calculations?

Mr. Stewart: The consultation document mentioned the joint arrangements, but I do not accept that there will be a raft of joint boards; we have consistently said that there is a range of possibilities for joint arrangements under a new structure. Indeed, joint arrangements of all sorts operate now. There are joint boards and joint arrangements between local authorities, and local authorities can get together to contract out services under competitive tendering, if they wish to do so.
The hon. Gentleman asked about on-going costs and pensions. Touche Ross has assumed that there will be an on-going pension cost. As for information technology and councillor numbers, I understand that Touche Ross made a conscious decision not to include them in on-going costs, as they were considered to be either very speculative or relatively insignificant. That was a reasonable decision for the consultants to take in the circumstances.
The hon. Gentleman asked me about transitional costs and the estimates for retirement and redundancy costs. Touche Ross assumed a severance package based on the terms available during the Greater London council break up. It used assumptions about the number of staff likely to be involved based on information that it obtained. Of course, different assumptions would produce different estimates, but that does not mean that one estimate is wrong and that another is right. The final cost will depend on the level of the severance package on offer and the number of staff retiring or made redundant.
The hon. Gentleman asked me about transitional costs and the winding up of the existing authorities. Touche Ross has assumed that whatever structure is chosen, all the existing authorities will have to be wound up. The work involved will not, therefore, vary with the structure. I am aware of the suggestion that the cost of winding up the existing authorities could be as high as £275 million. Frankly, I believe that those figures are simply wrong.

Mr. Dalyell: If the Minister believes that the figures are wrong, what is the Scottish Office estimate? We are told we are wrong; what does the Scottish Office think?

Mr. Stewart: I was about to respond to that point before the hon. Gentleman intervened. It is worth noting that other reputable commentators have suggested that the costs assigned by Touche Ross are too high, not too low. The hon. Member for Linlithgow quite reasonably wanted to know the Scottish Office estimate of the costs of winding up the existing authorities. Given that the commentators


have produced conflicting views, we are at present considering all the evidence that has been presented to us. We will set out the costs implications of the new structure when we publish the White Paper in due course.

Mr. Dalyell: That is a bit of a cop out. Who are those reputable commentators—

Mr. Deputy Speaker (Mr. Geoffrey Lofthouse): Order.

Mr. Stewart: I was not giving way, Mr. Deputy Speaker, as I have already given way several times to the hon. Gentleman. He rather delayed me as I was about to answer his question.
To sum up, I welcome this debate. It is an opportunity to put on the record the excellent work of Touche Ross and to put the matter wholly and reasonably into context. Local government in Scotland is an issue of great importance and we all agree about that. I have no doubt that there will be considerable debate in the coming months about every aspect of our proposals—and rightly so.
No doubt the hon. Member for Monklands, West will want to comment on the fact that there has been much correspondence from people in Airdrie saying that they do not wish to be associated with Coatbridge under the new structure. No doubt hon. Members will wish to debate many other factors.
It is important that the debate should be about things that matter—

Mr. Tom Clarke: What about Eastwood?

Mr. Stewart: A combination of Airdrie and Eastwood is not one of the illustrative structures put forward in the consultation paper.
I do not believe that selective nitpicking of the preliminary conclusions of Touche Ross on costs and savings are productive.

Mr. Dalyell: Is the Minister suggesting that my questions are nitpicking?

Mr. Stewart: I am not suggesting for a moment that the hon. Gentleman's questions are not valid. Of course they are valid and I have endeavoured to answer them as fully and as reasonably as I can. I hope that that takes the debate forward.
We now have evidence from a wide range of commentators in respect of the Touche Ross report. That allows us to proceed confidently and in full co-operation with our colleagues in the Treasury. The hon. Members for Linlithgow and for Monklands, West have put forward a thesis that there is some great split between the Treasury and the Scottish Office on these matters. I believe that it was the hon. Member for Fife, Central (Mr. McLeish) who said that the Treasury was outraged about the fact that it was being conned by the Scottish Office. I thought that that represented a world of fantasy wholly outside my experience of these matters.
We are proceeding with the co-operation of our colleagues in the Treasury to decide upon an appropriate single tier structure for Scotland. The detailed decisions, after the work—

The motion having been made after half-past Two o'clock and the debate having continued for half an hour, MR. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at four minutes past Three o'clock.